Document Detail


Impact of a reduced tube voltage on CT angiography and radiation dose: results of the PROTECTION I study.
MedLine Citation:
PMID:  19679281     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine the impact of a reduced 100-kV tube voltage on image quality and radiation exposure in a pre-defined subgroup analysis of the international, multicenter radiation dose survey PROTECTION I (Prospective Multicenter Study on RadiaTion Dose Estimates Of Cardiac CT AngIOgraphy I) study. BACKGROUND: Cardiac computed tomography angiography (CCTA) has become a frequently used diagnostic tool in clinical practice. Despite continually improving CT technology, there remain concerns regarding the associated radiation exposure. A reduced tube voltage of 100 kV has been proposed as an effective means for dose reduction in nonobese patients. METHODS: The study assessed the relevant radiation dose parameters as well as quantitative and qualitative diagnostic image quality data in a subgroup of 321 patients (100 kV: 82 patients; 120 kV: 239 patients), who were scanned at study sites that applied a 100-kV tube voltage in at least 1 patient. Diagnostic image quality was assessed by an experienced CCTA investigator with a 4-point score (1: nondiagnostic to 4: excellent image quality). Effective radiation dose was estimated from the dose-length-product of each CCTA study. RESULTS: The use of the 100-kV scan protocol was associated with 53% reduction in CCTA median radiation dose estimates, when compared with the conventional 120-kV scan protocol (p < 0.001). Although image noise significantly increased by 26.3% with 100 kV, signal- as well as contrast-to-noise ratios also increased by 7.9% (p = 0.254) and 10.8% (p = 0.027), respectively. Reduction of tube voltage did not impair diagnostic image quality (median diagnostic score: 3.5 [3.25 to 3.75] vs. 3.5 [3.0 to 3.75] for 100 kV vs. 120 kV; p = 0.22). CONCLUSIONS: In this nonrandomized PROTECTION I dose survey, reducing the CCTA tube voltage to 100 kV in nonobese patients is associated with a significant reduction in radiation exposure while maintaining diagnostic image quality. Thus, the 100-kV scan technique should be considered for CCTA dose reduction in adequately selected patients.
Authors:
Bernhard Bischoff; Franziska Hein; Tanja Meyer; Martin Hadamitzky; Stefan Martinoff; Albert Schömig; Jörg Hausleiter
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-14     Completed Date:  2009-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  940-6     Citation Subset:  IM    
Affiliation:
Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Klinik an der TU München, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Body Mass Index
Coronary Angiography / adverse effects,  methods*
Equipment Design
Humans
Logistic Models
Patient Selection
Predictive Value of Tests
Prospective Studies
Radiation Dosage*
Radiographic Image Interpretation, Computer-Assisted
Risk Assessment
Tomography, X-Ray Computed* / adverse effects
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2009 Aug;2(8):947-9   [PMID:  19679282 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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