Relationship between diverse patient body size- and image acquisition-related factors, and quantitative and qualitative image quality in coronary computed tomography angiography: a multicenter observational study.
OBJECTIVE
We investigated the effects of patient- and image acquisition-related factors on the image quality in coronary CT angiography (CCTA).


METHODS
We enrolled 1197 patients (728 men; 65 ± 12 years). All underwent CCTA under the routine scan protocol in 23 participating hospitals. The subjective image quality (3-point Likert scale: excellent, good, and poor) and the attenuation of the left and right coronary artery (LCA, RCA) were recorded; the effects of patient and image acquisition-related factors on vascular attenuation were then compared.


RESULTS
The mean LCA attenuation was 515.2 ± 65.8 (excellent), 401.4 ± 63.4 (good), and 319.5 ± 47.6 HU (poor). The corresponding RCA attenuation was 496.6 ± 67.6, 390.5 ± 58.5, and 308.5 ± 50.7 HU, respectively. Univariate analysis revealed significant associations between sufficient coronary attenuation (> 400 HU) and the age, gender, body surface area (BSA), number of detectors, contrast synchronization, scan mode, and the fractional contrast dose. Multivariate analysis revealed that the bolus tracking method, prospective electrocardiogram gating, and fractional contrast dose were significantly associated with sufficient coronary enhancement.


CONCLUSIONS
BSA and fractional contrast dose are the most important patient- and image acquisition-related factors for sufficient coronary attenuation in CCTA.
Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto City, 860-8556, Japan. utsunomi@kumamoto-u.ac.jp.
Daisuke
http://orcid.org/0000-0002-1723-1724
D
Utsunomiya
Division of Cardiovascular Radiology, Department of Radiology, Iwate Medical University Hospital, Morioka City, Japan.
Ryoichi
R
Tanaka
Division of Cardiovascular Radiology, Department of Radiology, Iwate Medical University Hospital, Morioka City, Japan.
Kunihiro
K
Yoshioka
Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima City, Japan.
Kazuo
K
Awai
Department of Radiology, Ehime University Graduate School of Medicine, Toon City, Japan.
Teruhito
T
Mochizuki
Department of Radiology, Yamaguchi University Graduate School of Medicine, Use City, Japan.
Naofumi
N
Matsunaga
Department of Radiology, International Medical Center, Saitama Medical University, Hidaka City, Japan.
Tomoaki
T
Ichikawa
Department of Diagnostic Radiology, Gifu Prefectural General Medical Center, Gifu City, Japan.
Masayuki
M
Kanematsu
Osaka University Graduate School of Medicine, Suita City, Japan.
Tonsok
T
Kim
Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto City, 860-8556, Japan.
Yasuyuki
Y
Yamashita
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D049628:Body Size; D001830:Body Surface Area; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
Body size; Contrast media; Coronary vessels; Multicenter study; Multidetector computed tomography