title: Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3(rd) generation dual-source CT.
abstract: OBJECTIVE
  To investigate the relationship between automated tube voltage selection (ATVS) and body mass index (BMI) and its effect on image quality and radiation dose of coronary CT angiography (CCTA).
  
  
  METHODS
  We evaluated 272 patients who underwent CCTA with 3(rd) generation dual-source CT (DSCT). Prospectively ECG-triggered spiral acquisition was performed with automated tube current selection and advanced iterative reconstruction. Tube voltages were selected by ATVS (70-120 kV). BMI, effective dose (ED), and vascular attenuation in the coronary arteries were recorded. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Five-point scales were used for subjective image quality analysis.
  
  
  RESULTS
  Image quality was rated good to excellent in 98.9 % of examinations without significant differences for proximal and distal attenuation (all p ≥ .0516), whereas image noise was rated significantly higher at 70 kV compared to ≥100 kV (all p < .0266). However, no significant differences were observed in SNR or CNR at 70-120 kV (all p ≥ .0829). Mean ED at 70-120 kV was 1.5 ± 1.2 mSv, 2.4 ± 1.5 mSv, 3.6 ± 2.7 mSv, 5.9 ± 4.0 mSv, 7.9 ± 4.2 mSv, and 10.7 ± 4.1 mSv, respectively (all p ≤ .0414). Correlation analysis showed a moderate association between tube voltage and BMI (r = .639).
  
  
  CONCLUSIONS
  ATVS allows individual tube voltage adaptation for CCTA performed with 3(rd) generation DSCT, resulting in significantly decreased radiation exposure while maintaining image quality.
  
  
  CONCLUSIONS
  • Automated tube voltage selection allows an individual tube voltage adaption in CCTA. • A tube voltage-based reduction of contrast medium volume is feasible. • Image quality was maintained while radiation exposure was significantly decreased. • A moderate association between tube voltage and body mass index was found.
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.|Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors: Stefanie
authors: S
authors: Mangold
authors: Division of Cardiovascular Imaging, 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: Julian L
authors: JL
authors: Wichmann
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA. schoepf@musc.edu.|Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA. schoepf@musc.edu.
authors: U Joseph
authors: UJ
authors: Schoepf
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
authors: Zachary B
authors: ZB
authors: Poole
authors: Siemens Medical Solutions, Malvern, PA, USA.
authors: Christian
authors: C
authors: Canstein
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
authors: Akos
authors: A
authors: Varga-Szemes
authors: Division of Cardiovascular Imaging, 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", Rome, Italy.
authors: Damiano
authors: D
authors: Caruso
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors: Fabian
authors: F
authors: Bamberg
authors: Department of Diagnostic and Interventional Radiology, Eberhard-Karls University Tuebingen, Tuebingen, Germany.
authors: Konstantin
authors: K
authors: Nikolaou
authors: Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
authors: Carlo N
authors: CN
authors: De Cecco
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D004334:Drug Administration Schedule; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies; D059629:Signal-To-Noise Ratio
chemical_list: D003287:Contrast Media
keywords: Automated tube voltage selection; Body mass index; Coronary CT angiography; Image quality; Radiation dose reduction