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Ultra-low-dose coronary artery calcium screening using multislice CT with retrospective ECG gating

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Abstract

The aim of this study was to reduce radiation exposure in multislice CT (MSCT) coronary artery calcium screening using different tube settings, and to determinate its impact on the detection and quantification of coronary artery calcification. Forty-eight patients underwent routine MSCT coronary artery calcium scoring (Somatom VolumeZoom, Siemens, Forchheim, Germany) with retrospective ECG-gated data acquisition. Scanning was performed with a 4×2.5-mm collimation. In each patient data acquisition was performed twice using tube settings of 120 kVp with 133 mAs (protocol 1) and of 80 kVp with 300 mAs (protocol 2). Together with the 80-kVp protocol additional online ECG-related tube current modulation (ECG pulsing) was used. Three-millimeter overlapping slices (increment 1.5 mm) were calculated for each data set. Semi-automated calcium quantification was performed calculating absolute Ca-hydroxylapatite mass. In addition to patient examinations, the radiation exposure for both protocols was evaluated using computed tomography dose index (CTDI) phantom measurements. Protocol 2 showed a significantly lower patient radiation exposure than protocol 1 (0.72 vs 2.04 mSv; p<0.0001). The CTDI phantom measurements revealed a 65% reduction of radiation dose. Calcium scoring results of both protocols showed a high correlation (r=0.99; p<0.0001) for absolute Ca-Hydroxylapatite mass measurements. Using 80-kVp protocols patient radiation exposure can be significantly reduced in MSCT coronary artery calcium screening without affecting the detection and quantification of coronary artery calcification; therefore, this technique should be used with retrospective ECG-gated cardiac CT examinations in patients with regular sinus rhythm.

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Authors and Affiliations

  1. Department of Clinical Radiology, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, 81377 , Munich, Germany

    Tobias F. Jakobs, Bernd J. Wintersperger, Peter Herzog, Maximilian F. Reiser & Christoph R. Becker

  2. Siemens Medical Solutions, Siemensstrasse 1, 91301, Forchheim, Germany

    Thomas Flohr & Christoph Suess

  3. Department of Cardiology, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, 81377 , Munich, Germany

    Andreas Knez

Authors
  1. Tobias F. Jakobs
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  2. Bernd J. Wintersperger
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  3. Peter Herzog
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  4. Thomas Flohr
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  5. Christoph Suess
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  6. Andreas Knez
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  7. Maximilian F. Reiser
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  8. Christoph R. Becker
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Correspondence to Tobias F. Jakobs.

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Jakobs, T.F., Wintersperger, B.J., Herzog, P. et al. Ultra-low-dose coronary artery calcium screening using multislice CT with retrospective ECG gating. Eur Radiol 13, 1923–1930 (2003). https://doi.org/10.1007/s00330-003-1895-7

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  • DOI: https://doi.org/10.1007/s00330-003-1895-7

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