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Original research article


Computed Tomography Angiography with a 192-slice Dual-source Computed Tomography System: Improvements in Image Quality and Radiation Dose.

Philip V M LinsenAdriaan CoenenMarisa M LubbersMarcel L DijkshoornMohamed OuhlousKoen Nieman
Departments of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Date of Submission: 24-Jul-2016, Date of Acceptance: 06-Sep-2016, Date of Web Publication: 21-Oct-2016.
Corresponding Author:
Corresponding Author

Philip V M Linsen

Department of Radiology, Erasmus Medical Center, CA‑207, s‑Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
E-mail: philiplinsen@hotmail.com

Corresponding Author:
Corresponding Author

Philip V M Linsen

Department of Radiology, Erasmus Medical Center, CA‑207, s‑Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
E-mail: philiplinsen@hotmail.com

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ABSTRACT



Purpose: This study aims to compare image quality, radiation dose, and the influence of the heart rate on image quality of high-pitch spiral coronary computed tomography angiography (CCTA) using 128-slice (second generation) dual-source CT (DSCT) and a 192-slice DSCT (third generation) scanner.
Materials and Methods: Two consecutive cohorts of fifty patients underwent CCTA by high-pitch spiral scan mode using 128 or 192-slice DSCT. The 192-slice DSCT system has a more powerful roentgen tube (2 × 120 kW) that allows CCTA acquisition at lower tube voltages, wider longitudinal coverage for faster table speed (732 m/s), and the use of iterative reconstruction. Objective image quality was measured as the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was evaluated using a Likert scale.
Results: While the effective dose was lower with 192-slice DSCT (1.2 ± 0.5 vs. 0.6 ± 0.3 mSv; P < 0.001), the SNR (18.9 ± 4.3 vs. 11.0 ± 2.9; P < 0.001) and CNR (23.5 ± 4.8 vs. 14.3 ± 4.1; P < 0.001) were superior to 128-slice DSCT. Although patients scanned with 192-slice DSCT had a faster heart rate (59 ± 7 vs. 56 ± 6; P = 0.045), subjective image quality was scored higher (4.2 ± 0.8 vs. 3.0 ± 0.7; P < 0.001) compared to 128-slice DSCT.
Conclusions: High-pitch spiral CCTA by 192-slice DSCT provides better image quality, despite a higher average heart rate, at lower radiation doses compared to 128-slice DSCT.
Keywords: Computed Tomography, Coronary Angiography, Heart Rate, Image Quality, Radiation Dose

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