Low-tube-voltage selection for triple-rule-out CTA: relation to patient size.
OBJECTIVE
To investigate the relationship between image quality and patient size at 100 kilovoltage (kV) compared to 120 kV ECG-gated Triple-Rule-Out CT angiography (TRO-CTA).


METHODS
We retrospectively included 73 patients (age 64 ± 14 years) who underwent retrospective ECG-gated chest CTA. 40 patients were scanned with 100 kV while 33 patients with 120 kV. Body mass index (BMI), patients' chest circumference (PC) and thoracic surface area (TSA) were recorded. Quantitative image quality was assessed as vascular attenuation in the ascending aorta (AA), pulmonary trunk (PA) and left coronary artery (LCA) and the signal-to-noise ratio (SNR) in the AA.


RESULTS
There was no significant difference in BMI (26.0 ± 4.6 vs. 28.0 ± 6.7 kg/m2), PC (103 ± 7 vs. 104 ± 10 cm2) and TSA (92 ± 15 vs. 91 ± 19 cm2) between 100 kV and 120 kV group. Mean vascular attenuation was significantly higher in the 100 kV compared to the 120 kV group (AA 438 vs. 354 HU, PA 460 vs. 349 HU, LCA 370 vs. 299 HU all p < 0.001). SNR was not significantly different, even after adjusting for patient size. Radiation dose was significantly lower in the 100 kV group (10.7 ± 4.1 vs. 20.7 ± 10.7 mSv; p < 0.001).


CONCLUSIONS
100 kV TRO-CTA is feasible in normal-to-overweight patients while maintaining image quality and achieving substantial dose reduction.


CONCLUSIONS
• 100 kV protocols result in a significantly lower radiation dose. • Mean vascular attenuation is significantly higher using 100 kV. • SNR and CNR are not significantly different between 100 kV and 120 kV. • 100 kV CTA is feasible regardless of patient size while maintaining image quality.
Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3584 CX, Utrecht, The Netherlands. r.a.p.takx@umcutrecht.nl.
Richard A P
RAP
Takx
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.|Department of Diagnostic and Interventional Radiology, Hufeland Klinikum GmbH, Bad Langensalza, Germany.
Radko
R
Krissak
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.|Department of Radiology, General Hospital Celle, Celle, Germany.
Christian
C
Fink
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.
Valentin
V
Bachmann
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.
Thomas
T
Henzler
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.
Mathias
M
Meyer
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
John W
JW
Nance
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.
Stefan O
SO
Schoenberg
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany.|Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Paul
P
Apfaltrer
D001011:Aorta / Q000000981:diagnostic imaging; D015992:Body Mass Index; D049628:Body Size; D000072226:Computed Tomography Angiography / Q000379:methods / Q000592:standards*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000000981:diagnostic imaging*; D011651:Pulmonary Artery; D011829:Radiation Dosage; D012189:Retrospective Studies; D059629:Signal-To-Noise Ratio
Body mass index; Chest pain; Image enhancement; Multidetector computed tomography; Radiation dosage
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