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Original research article


Effect of Tube Voltage (100 vs. 120 kVp) on Radiation Dose and Image Quality using Prospective Gating 320 Row Multi-detector Computed Tomography Angiography.

Atif N KhanFaisal KhosaWaqas ShuaibKhurram NasirRon BlanksteinMelvin Clouse
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, Department of Radiology, Emory University Hospital Midtown, Atlanta, GA, Department of Cardiology, Yale University School of Medicine, New Haven, CT Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
Date of Submission: 20-Mar-2013, Date of Acceptance: 07-May-2013, Date of Web Publication: 31-Dec-2013.
Corresponding Author:

Waqas Shuaib

Department of Radiology and Imaging Sciences, Division of Emergency Radiology, Emory University Hospital Midtown, 550 Peachtree Street NE. Atlanta, GA 30308 Office: (404) 686‑5957, FAX: (404) 686‑4498.
E-mail: waqas.shuaib@emory.edu

Corresponding Author:

Waqas Shuaib

Department of Radiology and Imaging Sciences, Division of Emergency Radiology, Emory University Hospital Midtown, 550 Peachtree Street NE. Atlanta, GA 30308 Office: (404) 686‑5957, FAX: (404) 686‑4498.
E-mail: waqas.shuaib@emory.edu

DOI: 10.4103/2156-7514.124092 Facebook Twitter Google Linkedin

ABSTRACT



Objectives: The objective of the following study is to evaluate the effect of reducing tube voltage from 120 to 100 kVp using prospective gating 320 row multi-detector computed tomography angiography on image quality and reduction in radiation dose.
Materials and Methods: A total of 78 sequential patients were scanned with prospective electrocardiogram gating. A total of 45 patients (Group 1) with mean body mass index (BMI) 29 ± 2 and heart rate (HR) 57 ± 7 beats per minute (BPM) were scanned at 120 kVp. 33 patients (Group 2) with mean BMI 23 ± 3 and HR 58 ± 6 bpm were scanned at 100 kVp. Effective dose was calculated using dose length product and factor (k = 0.014). Quantitative assessment of image quality was calculated by measuring signal to noise ratio (SNR) and contrast to noise ratio (CNR) in the left ventricle and left main coronary artery. Two experienced cardiac radiologists using a three-point ordinal scale assessed subjectively image quality.
Results: In Group 1, the median radiation dose was 5.31 mSv (95% confidence interval [CI]: 4.86-6.09) and for Group 2 (P = 0.009) the mean radiation dose was 3.71 mSv (95% CI: 2.76-4.87), representing 30% decrease in radiation dose. In multivariate analyses, adjusting for age, gender, HR, BMI, tube current and scan length, an absolute median reduction of 2.21 mSv (1.13-3.29 mSv) was noted in patients scanned with 100 kVp (P < 0.0001). The quantitative image quality (SNR and CNR) was not statistically significant between the groups. Subjective image quality was rated as good or excellent in 99% of coronary segments for both groups (P value was considered as non-significant).
Conclusion: Our study suggests that radiation dose may be lowered from 120 to 100 kVp with preservation of image quality in patient’s whose BMI is ≤27.
Keywords: Dose Reduction, Image Quality, Multi-detector Computed Tomography Angiography, Tube Voltage

Cited in 4 Documents

  1. D. J. Murphy, A. Aghayev and M. L. Steigner (2018) Vascular CT and MRI: a practical guide to imaging protocols. Insights Imaging 9(2):215. doi: 10.1007/s13244-018-0597-2
  2. MohammadK Khan, Faisal Khosa, Boris Nikolic, Waqas Shuaib, Pei-JanPaul Lin and AtifN Khan (2014) Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening. J Clin Imaging Sci 4(1):18. doi: 10.4103/2156-7514.131640
  3. Jason Kinnin, Tarek N. Hanna, Marc Jutras, Babar Hasan, Rick Bhatia and Faisal Khosa (2018) Top 100 Cited articles on Radiation Exposure in Medical Imaging: A Bibliometric Analysis. Current Problems in Diagnostic Radiology :. doi: 10.1067/j.cpradiol.2018.03.005
  4. Sock Keow Tan, Chai Hong Yeong, Raja Rizal Azman Raja Aman, Kwan Hoong Ng, Yang Faridah Abdul Aziz, Kok Han Chee and Zhonghua Sun (2018) Low tube voltage prospectively ECG-triggered coronary CT angiography: a systematic review of image quality and radiation dose. BJR :20170874. doi: 10.1259/bjr.20170874

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