title: Optimizing radiation dose by using advanced modelled iterative reconstruction in high-pitch coronary CT angiography.
abstract: OBJECTIVE
  To evaluate the potential of advanced modeled iterative reconstruction (ADMIRE) for optimizing radiation dose of high-pitch coronary CT angiography (CCTA).
  
  
  METHODS
  High-pitch 192-slice dual-source CCTA was performed in 25 patients (group 1) according to standard settings (ref. 100 kVp, ref. 270 mAs/rot). Images were reconstructed with filtered back projection (FBP) and ADMIRE (strength levels 1-5). In another 25 patients (group 2), high-pitch CCTA protocol parameters were adapted according to results from group 1 (ref. 160 mAs/rot), and images were reconstructed with ADMIRE level 4. In ten patients of group 1, vessel sharpness using full width at half maximum (FWHM) analysis was determined. Image quality was assessed by two independent, blinded readers.
  
  
  RESULTS
  Interobserver agreements for attenuation and noise were excellent (r = 0.88/0.85, p < 0.01). In group 1, ADMIRE level 4 images were most often selected (84%, 21/25) as preferred data set; at this level noise reduction was 40% compared to FBP. Vessel borders showed increasing sharpness (FWHM) at increasing ADMIRE levels (p < 0.05). Image quality in group 2 was similar to that of group 1 at ADMIRE levels 2-3. Radiation dose in group 2 (0.3 ± 0.1 mSv) was significantly lower than in group 1 (0.5 ± 0.3 mSv; p < 0.05).
  
  
  CONCLUSIONS
  In a selected population, ADMIRE can be used for optimizing high-pitch CCTA to an effective dose of 0.3 mSv.
  
  
  CONCLUSIONS
  • Advanced modeled IR (ADMIRE) reduces image noise up to 50% as compared to FBP. • Coronary artery vessel borders show an increasing sharpness at higher ADMIRE levels. • High-pitch CCTA with ADMIRE is possible at a radiation dose of 0.3 mSv.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Gordic
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.|Divison of Radiology and Nuclear Medicine, Kantonsspital, St. Gallen, Switzerland.
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.affiliation: Siemens Healthcare, Computed Tomography Division, Forchheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Sedlmair
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.|Clinic of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.|Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Manka
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: André
authors.initials: A
authors.lastname: Plass
authors.affiliation: Siemens Healthcare, Computed Tomography Division, Forchheim, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Husarik
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.affiliation: Divison of Radiology and Nuclear Medicine, Kantonsspital, St. Gallen, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Wildermuth
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland. hatem.alkadhi@usz.ch.
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.|Divison of Radiology and Nuclear Medicine, Kantonsspital, St. Gallen, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; Coronary angiography; Image quality; Iterative reconstruction; Radiation dose