Key result
New iterative reconstruction cuts radiation dose up to ~86% while maintaining phantom Agatston scores.
Why the study?
Radiation exposure during coronary artery calcium scoring should be minimized while maintaining accurate risk assessment.
Does a new iterative reconstruction algorithm allow for radiation dose reduction in coronary artery calcium scoring without compromising Agatston scores in an in vitro model?
Does a new iterative reconstruction algorithm allow for radiation dose reduction in coronary artery calcium scoring without compromising Agatston scores in an in vitro model?
p-value: p=<0.001
A new iterative reconstruction algorithm allows for up to 86% reduction in radiation dose during coronary artery calcium scoring in an in vitro model while maintaining accurate Agatston scores.
Phantom data indicate feasible CAC dose reduction with IR; clinical validation required before practice change.
BACKGROUND: Coronary artery calcium (CAC) scoring is a widespread tool for cardiac risk assessment in asymptomatic patients and accompanying possible adverse effects, i.e. radiation exposure, should be as low as reasonably achievable. PURPOSE: To evaluate a new iterative reconstruction (IR) algorithm for dose reduction of in vitro coronary artery calcium scoring at different tube currents. MATERIAL AND METHODS: An anthropomorphic calcium scoring phantom was scanned in different configurations simulating slim, average-sized, and large patients. A standard calcium scoring protocol was performed on a third-generation dual-source CT at 120 kVp tube voltage. Reference tube current was 80 mAs as standard and stepwise reduced to 60, 40, 20, and 10 mAs. Images were reconstructed with weighted filtered back projection (wFBP) and a new version of an established IR kernel at different strength levels. Calcifications were quantified calculating Agatston and volume scores. Subjective image quality was visualized with scans of an ex vivo human heart. RESULTS: < 0.001). Depending on selected parameters, radiation dose could be lowered by up to 86% in the large size phantom when selecting a reference tube current of 10 mAs with resulting Agatston levels close to the reference settings. CONCLUSION: New iterative reconstruction kernels may allow for reduction in tube current for established Agatston scoring protocols and consequently for substantial reduction in radiation exposure.
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Gassenmaier et al. (2017) studied Coronary artery calcium scoring. New iterative reconstruction (IR) algorithm vs. Weighted filtered back projection (wFBP) was evaluated on Agatston and volume scores and radiation dose reduction (p=<0.001). A new iterative reconstruction algorithm allowed for up to 86% radiation dose reduction in a large size phantom while maintaining Agatston levels close to reference settings (P<0.001).
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