title: Quantitative assessment on coronary computed tomography angiography (CCTA) image quality: comparisons between genders and different tube voltage settings.
abstract: BACKGROUND
  This study was carried out to quantify and compare the quantitative image quality of coronary computed tomography angiography (CCTA) between genders as well as between different tube voltages scan protocols.
  
  
  METHODS
  Fifty-five cases of CCTA were collected retrospectively and all images including reformatted axial images at systolic and diastolic phases as well as images with curved multi planar reformation (cMPR) were obtained. Quantitative image quality including signal intensity, image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of right coronary artery (RCA), left anterior descending artery (LAD), left circumflex artery (LCx) and left main artery (LM) were quantified using Analyze 12.0 software.
  
  
  RESULTS
  Six hundred and fifty-seven coronary arteries were evaluated. There were no significant differences in any quantitative image quality parameters between genders. 100 kilovoltage peak (kVp) scanning protocol produced images with significantly higher signal intensity compared to 120 kVp scanning protocol (P<0.001) in all coronary arteries in all types of images. Higher SNR was also observed in 100 kVp scan protocol in all coronary arteries except in LCx where 120 kVp showed better SNR than 100 kVp.
  
  
  CONCLUSIONS
  There were no significant differences in image quality of CCTA between genders and different tube voltages. Lower tube voltage (100 kVp) scanning protocol is recommended in clinical practice to reduce the radiation dose to patient.
authors.affiliation: Diagnostic Imaging & Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Teo Chee
authors.initials: TC
authors.lastname: Chian
authors.affiliation: Diagnostic Imaging & Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Norziana Mat
authors.initials: NM
authors.lastname: Nassir
authors.affiliation: Diagnostic Imaging & Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Mohd Izuan
authors.initials: MI
authors.lastname: Ibrahim
authors.affiliation: Department of Cardiology, National Heart Institute, 50400 Kuala Lumpur, Malaysia.
authors.forename: Ahmad Khairuddin Md
authors.initials: AK
authors.lastname: Yusof
authors.affiliation: Diagnostic Imaging & Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Akmal
authors.initials: A
authors.lastname: Sabarudin
keywords: Coronary computed tomography angiography (CCTA); coronary artery; genders; kilovoltage peak (kVp); quantitative image quality assessment