title: Coronary CT angiography in obese patients using 3(rd) generation dual-source CT: effect of body mass index on image quality.
abstract: OBJECTIVE
  To evaluate the image quality of coronary CT angiography (CCTA) in obese patients using a 3(rd) generation, dual-source CT scanner.
  
  
  METHODS
  We retrospectively evaluated 102 overweight and obese patients who had undergone CCTA. Studies were performed with 3(rd) generation dual-source CT, prospectively ECG-triggered acquisition at 120 kV, and automated tube current modulation. Advanced modeled iterative reconstruction was used. Patients were divided into three BMI groups: 1)25-29.9 kg/m(2); 2)30-39.9 kg/m(2); 3) ≥ 40 kg/m(2). Vascular attenuation in the coronary arteries was measured. Contrast-to-noise ratio (CNR) was calculated. Image quality was subjectively evaluated using five-point scales.
  
  
  RESULTS
  Image quality was considered diagnostic in 97.6 % of examinations. CNR was consistently adequate in all groups but decreased for groups 2 and 3 in comparison to group 1 as well as for group 3 compared to group 2 (p = 0.001, respectively). Subjective image quality was significantly higher in group 1 compared to group 3 (attenuation proximal: 4.8 ± 0.4 vs. 4.4 ± 0.6, p = 0.011; attenuation distal: 4.5 ± 0.7 vs. 4.0 ± 0.8, p = 0.019; noise: 4.7 ± 0.6 vs. 3.8 ± 0.7, p < 0.001). The mean effective dose was 9.5 ± 3.9 mSv for group 1, 11.4 ± 4.7 mSv for group 2 and 14.0 ± 6.4 mSv for group 3.
  
  
  CONCLUSIONS
  Diagnostic image quality can be routinely obtained at CCTA in obese patients with 3(rd) generation DSCT at 120 kV.
  
  
  CONCLUSIONS
  • Diagnostic CCTA can be routinely performed in obese patients with 3 (rd) generation DSCT. • 120-kV tube voltage allows diagnostic image quality in patients with BMI > 40 kg/m (2) . • 80-ml contrast medium can be administered without significant decline in vascular attenuation.
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.|Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Mangold
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.|Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA. schoepf@musc.edu.|Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. schoepf@musc.edu.
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.affiliation: Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Sheldon E
authors.initials: SE
authors.lastname: Litwin
authors.affiliation: Siemens Medical Solutions, Malvern, PA, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Canstein
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.
authors.forename: Akos
authors.initials: A
authors.lastname: Varga-Szemes
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.|Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza", Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Fuller
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Stubenrauch
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies
keywords: Body mass index; Coronary computed tomography angiography; Dual-source; Obesity; Tube current