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SHR Neuro Cancer Cardio Lipid Metab Microb

Albrecht, MH; Nance, JW; Schoepf, UJ; Jacobs, BE; Bayer, RR; Litwin, SE; Reynolds, MA; Otani, K; Mangold, S; Varga-Szemes, A; De, Santis, D; Eid, M; Apfaltrer, G; Tesche, C; Goeller, M; Vogl, TJ; De, Cecco, CN.
Diagnostic accuracy of low and high tube voltage coronary CT angiography using an X-ray tube potential-tailored contrast medium injection protocol.
Eur Radiol. 2018; 28(5):2134-2142 Doi: 10.1007/s00330-017-5150-z
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Apfaltrer Georg
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Abstract:: OBJECTIVES: To compare the diagnostic accuracy between low-kilovolt peak (kVp) (≤ 100) and high-kVp (> 100) third-generation dual-source coronary CT angiography (CCTA) using a kVp-tailored contrast media injection protocol. METHODS: One hundred twenty patients (mean age = 62.6 years, BMI = 29.0 kg/m²) who underwent catheter angiography and CCTA with automated kVp selection were separated into two cohorts (each n = 60, mean kVp = 84 and 117). Contrast media dose was tailored to the kVp level: 70 = 40 ml, 80 = 50 ml, 90 = 60 ml, 100 = 70 ml, 110 = 80 ml, and 120 = 90 ml. Contrast-to-noise ratio (CNR) was measured. Two observers evaluated image quality and the presence of significant coronary stenosis (> 50% luminal narrowing). RESULTS: Diagnostic accuracy (sensitivity/specificity) with ≤ 100 vs. > 100 kVp CCTA was comparable: per patient = 93.9/92.6% vs. 90.9/92.6%, per vessel = 91.5/97.8% vs. 94.0/96.8%, and per segment = 90.0/96.7% vs. 90.7/95.2% (all P > 0.64). CNR was similar (P > 0.18) in the low-kVp vs. high-kVp group (12.0 vs. 11.1), as ws subjective image quality (P = 0.38). Contrast media requirements were reduced by 38.1% in the low- vs. high-kVp cohort (53.6 vs. 86.6 ml, P < 0.001) and radiation dose by 59.6% (4.3 vs. 10.6 mSv, P < 0.001). CONCLUSIONS: Automated tube voltage selection with a tailored contrast media injection protocol allows CCTA to be performed at ≤ 100 kVp with substantial dose reductions and equivalent diagnostic accuracy for coronary stenosis detection compared to acquisitions at > 100 kVp. KEY POINTS: • Low-kVp coronary CT angiography (CCTA) enables reduced contrast and radiation dose. • Diagnostic accuracy is comparable between ≤ 100 and > 100 kVp CCTA. • Image quality is similar for low- and high-kVp CCTA. • Low-kVp image acquisition is facilitated by automated tube voltage selection. • Tailoring contrast injection protocols to the automatically selected kVp-level is feasible.
Find related publications in this database (using NLM MeSH Indexing): Aged - administration & dosage; Computed Tomography Angiography - methods; Contrast Media - administration & dosage; Coronary Angiography - methods; Coronary Stenosis - diagnosis; Female - administration & dosage; Follow-Up Studies - administration & dosage; Humans - administration & dosage; Injections, Intra-Arterial - administration & dosage; Male - administration & dosage; Middle Aged - administration & dosage; ROC Curve - administration & dosage; Radiation Dosage - administration & dosage
Find related publications in this database (Keywords): Coronary CT angiography; Diagnostic accuracy; Tube voltage; Radiation dose; Contrast media dose