Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Apfaltrer, G; Albrecht, MH; Schoepf, UJ; Duguay, TM; De, Cecco, CN; Nance, JW; De, Santis, D; Apfaltrer, P; Eid, MH; Eason, CD; Thompson, ZM; Bauer, MJ; Varga-Szemes, A; Jacobs, BE; Sorantin, E; Tesche, C.
High-pitch low-voltage CT coronary artery calcium scoring with tin filtration: accuracy and radiation dose reduction.
Eur Radiol. 2018; 28(7):3097-3104
Doi: 10.1007/s00330-017-5249-2
Web of Science
PubMed
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FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Apfaltrer Georg
- Co-Autor*innen der Med Uni Graz
- Apfaltrer Paul
- Sorantin Erich
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- Abstract:
- OBJECTIVES: To investigate diagnostic accuracy and radiation dose of high-pitch CT coronary artery calcium scoring (CACS) with tin filtration (Sn100kVp) versus standard 120kVp high-pitch acquisition. METHODS: 78 patients (58% male, 61.5±9.1 years) were prospectively enrolled. Subjects underwent clinical 120kVp high-pitch CACS using third-generation dual-source CT followed by additional high-pitch Sn100kVp acquisition. Agatston scores, calcium volume scores, Agatston score categories, percentile-based risk categorization and radiation metrics were compared. RESULTS: 61/78 patients showed coronary calcifications. Median Agatston scores were 34.9 [0.7-197.1] and 41.7 [0.7-207.2] and calcium volume scores were 34.1 [0.7-218.0] for Sn100kVp and 35.7 [1.1-221.0] for 120kVp acquisitions, respectively (both p<0.0001). Bland-Altman analysis revealed underestimated Agatston scores and calcium volume scores with Sn100kVp versus 120kVp acquisitions (mean difference: 16.4 and 11.5). However, Agatston score categories and percentile-based risk categories showed excellent agreement (ĸ=0.98 and ĸ=0.99). Image noise was 25.8±4.4HU and 16.6±2.9HU in Sn100kVp and 120kVp scans, respectively (p<0.0001). Dose-length-product was 9.9±4.8mGy*cm and 40.9±14.4mGy*cm with Sn100kVp and 120kVp scans, respectively (p<0.0001). This resulted in significant effective radiation dose reduction (0.13±0.07mSv vs. 0.57±0.2mSv, p<0.0001) for Sn100kVp acquisitions. CONCLUSION: CACS using high-pitch low-voltage tin-filtered acquisitions demonstrates excellent agreement in Agatston score and percentile-based cardiac risk categorization with standard 120kVp high-pitch acquisitions. Furthermore, radiation dose was significantly reduced by 78% while maintaining accurate risk prediction. KEY POINTS: • Coronary artery calcium scoring with tin filtration reduces radiation dose by 78%. • There is excellent correlation between high-pitch Sn100kVp and standard 120kVp acquisitions. • Excellent agreement regarding Agatston score categories and percentile-based risk categorization was achieved. • No cardiac risk reclassifications were observed using Sn100kVp coronary artery calcium scoring.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Calcinosis - diagnostic imaging
- Calcium - administration & dosage
- Coronary Angiography - methods
- Coronary Artery Disease - diagnostic imaging
- Female - administration & dosage
- Filtration - methods
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Prognosis - administration & dosage
- Prospective Studies - administration & dosage
- Radiation Dosage - administration & dosage
- Radiographic Image Interpretation, Computer-Assisted - methods
- Reproducibility of Results - administration & dosage
- Risk Assessment - methods
- Tin - administration & dosage
- Tomography, X-Ray Computed - methods
- Find related publications in this database (Keywords)
- Computed tomography
- Coronary artery calcium
- Tin filtration
- High-pitch
- Radiation dose