title: Approaches to ultra-low radiation dose coronary artery calcium scoring based on 3rd generation dual-source CT: A phantom study.
abstract: OBJECTIVE
  To investigate to what extent 3rd generation dual-source computed tomography (DSCT) can reduce radiation dose in coronary artery calcium scoring.
  
  
  METHODS
  Image acquisition was performed using a stationary calcification phantom. Prospectively electrocardiogram (ECG)-triggered 120 kV sequential, and 120 and Sn100 kV ultra-high pitch (UHP) acquisitions were performed with different tube currents (80, 60, 40, 20 mA). Images were reconstructed using filtered back projection (FBP) and 3rd generation iterative reconstruction (IR). Contrast-to-noise ratio (CNR), Agatston score, calcium volume, and radiation dose were assessed. For statistical analysis Friedman tests and Wilcoxon rank sum tests were used.
  
  
  RESULTS
  Even at reduced tube currents, the three acquisition techniques did not show significant differences in Agatston score (p=0.4) or calcium volume (p=0.08) with FBP reconstruction. Calcium volumes were significantly lower for 3rd generation IR compared to FBP reconstructions (p<0.01). CTDIvol for the 120 kV sequential, 120 and Sn100 kV UHP acquisitions at 80 and 20 mA were 1.2-0.37, 0.48-0.17, and 0.07-0.02 mGy, respectively.
  
  
  CONCLUSIONS
  3rd generation DSCT enabled a reduction of tube current in both the sequential and UHP acquisitions without significantly affecting coronary calcium scoring. Tin filtered 100 kV scanning may allow accurate quantification of calcium score without correction of the HU threshold.
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: McQuiston
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Muscogiuri
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA. Electronic address: schoepf@musc.edu.
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Felix G
authors.initials: FG
authors.lastname: Meinel
authors.affiliation: Siemens Medical Solutions, Malvern, PA, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Canstein
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Akos
authors.initials: A
authors.lastname: Varga-Szemes
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Scuola di Specializzazione in Radiodiagnostica, University of Milan, Milan, Italy.
authors.forename: Paola M
authors.initials: PM
authors.lastname: Cannao'
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.affiliation: Siemens Healthcare, Forchheim, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Allmendinger
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Center for Medical Imaging-North East Netherlands, Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza"-Polo Pontino, Latina, Italy.
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
mesh_terms: D000465:Algorithms; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D004562:Electrocardiography; D006801:Humans; D008297:Male; D019047:Phantoms, Imaging; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Agatston score; Dual-source CT; Iterative reconstruction; Radiation dose; Ultra-high-pitch acquisition