AI Article Synopsis
- Evaluating radiation dose and image quality for CCTA protocols in non-obese patients using high-strength deep learning image reconstructions (DLIR-H) versus standard adaptive statistical iterative reconstruction (ASiR-V).
- The study included 255 patients, divided into three groups based on varying kilovolt peak (kVp) and iodine delivery rates (IDR).
- Results showed that using DLIR-H at 80 kVp with a 1.4 IDR significantly reduced radiation dose by 42% and improved image quality metrics compared to the standard 100 kVp protocol.
- The findings indicate that DLIR-H provides a safer and more effective imaging option for coronary CT angiography by minimizing radiation and contrast exposure while enhancing image clarity.
Article Abstract
Objective: To evaluate radiation dose and image quality of a double-low CCTA protocol reconstructed utilizing high-strength deep learning image reconstructions (DLIR-H) compared to standard adaptive statistical iterative reconstruction (ASiR-V) protocol in non-obese patients.
Materials And Methods: From June to October 2022, consecutive patients, undergoing clinically indicated CCTA, with BMI < 30 kg/m were prospectively included and randomly assigned into three groups: group A (100 kVp, ASiR-V 50%, iodine delivery rate [IDR] = 1.8 g/s), group B (80 kVp, DLIR-H, IDR = 1.4 g/s), and group C (80 kVp, DLIR-H, IDR = 1.2 g/s). High-concentration contrast medium was administered. Image quality analysis was evaluated by two radiologists. Radiation and contrast dose, and objective and subjective image quality were compared across the three groups.
Results: The final population consisted of 255 patients (64 ± 10 years, 161 men), 85 per group. Group B yielded 42% radiation dose reduction (2.36 ± 0.9 mSv) compared to group A (4.07 ± 1.2 mSv; p < 0.001) and achieved a higher signal-to-noise ratio (30.5 ± 11.5), contrast-to-noise-ratio (27.8 ± 11), and subjective image quality (Likert scale score: 4, interquartile range: 3-4) compared to group A and group C (all p ≤ 0.001). Contrast medium dose in group C (44.8 ± 4.4 mL) was lower than group A (57.7 ± 6.2 mL) and B (50.4 ± 4.3 mL), all the comparisons were statistically different (all p < 0.001).
Conclusion: DLIR-H combined with 80-kVp CCTA with an IDR 1.4 significantly reduces radiation and contrast medium exposure while improving image quality compared to conventional 100-kVp with 1.8 IDR protocol in non-obese patients.
Clinical Relevance Statement: Low radiation and low contrast medium dose coronary CT angiography protocol is feasible with high-strength deep learning reconstruction and high-concentration contrast medium without compromising image quality.
Key Points: Minimizing the radiation and contrast medium dose while maintaining CT image quality is highly desirable. High-strength deep learning iterative reconstruction protocol yielded 42% radiation dose reduction compared to conventional protocol. "Double-low" coronary CTA is feasible with high-strength deep learning reconstruction without compromising image quality in non-obese patients.
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| http://dx.doi.org/10.1007/s00330-024-11059-x | DOI Listing |
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