title: Comparison of coronary CT angiography image quality with and without breast shields.
abstract: OBJECTIVE
  The purpose of this study is to compare the image quality of coronary CT angiography performed with and without breast shields.
  
  
  METHODS
  This study involved a retrospective cohort of 72 women with possible angina who underwent 64-MDCT retrospective ECG-gated coronary CT angiography at a single academic tertiary medical center. Images of 36 women scanned while wearing bismuth-coated latex breast shields and 36 control subjects scanned without shields, matched by heart rate and body mass index, were graded on a standardized Likert scale for image quality, stenosis, and plaque by two independent board-certified readers blinded to breast shields.
  
  
  RESULTS
  Seventy-two patients (mean [± SD] age, 53 ± 9 years) were included. The pre scan heart rate, body mass index, and Agatston score did not differ between groups. The median estimated radiation dose was 13.4 versus 16.1 mSv for those with and without breast shields (p = 0.003). For shielded versus unshielded scans, 86% versus 83% of coronary segments were rated excellent or above average (p = 0.4), median image quality was 2.0 for both groups, mean signal was 474 ± 75 and 452 ± 91 HU (p = 0.27), mean noise was 33.9 ± 8.5 and 29.8 ± 8.3 HU (p = 0.04), and median signal-to-noise ratio was 14.4 and 14.7 (p = 0.56), respectively.
  
  
  CONCLUSIONS
  Breast shields for women undergoing coronary CT angiography slightly increased noise but did not negatively affect signal, signal-to-noise ratio, quality, or interpretability. Breast shield use warrants further study.
authors: Cardiology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA. ehulten@partners.org
authors: Edward
authors: E
authors: Hulten
authors: Patrick
authors: P
authors: Devine
authors: Timothy
authors: T
authors: Welch
authors: Irwin
authors: I
authors: Feuerstein
authors: Allen
authors: A
authors: Taylor
authors: Sara
authors: S
authors: Petrillo
authors: Minnetta
authors: M
authors: Luncheon
authors: Binh
authors: B
authors: Nguyen
authors: Todd C
authors: TC
authors: Villines
mesh_terms: D001940:Breast; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D011835:Radiation Protection / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*