Impact of a Reduced Tube Voltage on CT Angiography and Radiation Dose Results of the PROTECTION I Study
Impact of a Reduced Tube Voltage on CT Angiography and Radiation Dose Results of the PROTECTION I Study
复制标题
DOI：
10.1016/j.jcmg.2009.02.015
复制
发表时间：
2009-08-01
影响因子：
14
通讯作者：
Hausleiter, Joerg
中科院分区：
文献类型：
--
作者：
Bischoff, Bernhard;Hein, Franziska;Hausleiter, Joerg
目的 本研究的目的是在国际多中心辐射剂量调查保护 I（心脏 CT 血管造影辐射剂量估计的前瞻性多中心研究 I）研究的预定义亚组分析中确定降低 100 kV 管电压对图像质量和辐射暴露的影响。 背景 心脏计算机断层扫描血管造影 (CCTA) 已成为临床实践中常用的诊断工具。尽管 CT 技术不断改进，但相关辐射暴露仍然令人担忧。已提出降低 100 kV 管电压作为非肥胖患者减少剂量的有效手段。 方法 该研究评估了 321 名患者亚组（100 kV：82 名患者；120 kV：239 名患者）的相关辐射剂量参数以及定量和定性诊断图像质量数据，这些患者在至少 1 名患者施加 100 kV 管电压的研究地点进行了扫描。诊断图像质量由经验丰富的 CCTA 调查员进行评估，评分为 4 分（1：无法诊断，4：图像质量极佳）。有效辐射剂量根据每项 CCTA 研究的剂量长度乘积进行估计。 结果 与传统 120 kV 扫描方案相比，使用 100 kV 扫描方案可使 CCTA 中位辐射剂量估计值减少 53% (p < 0.001)。尽管图像噪声在 100 kV 时显着增加了 26.3%，但信号和对比度噪声比也分别增加了 7.9% (p = 0.254) 和 10.8% (p = 0.027)。管电压的降低不会影响诊断图像质量（中位诊断评分：100 kV 与 120 kV 分别为 3.5 [3.25 至 3.75] 与 3.5 [3.0 至 3.75]；p = 0.22）。结论 在这项非随机保护 I 剂量调查中，将非肥胖患者的 CCTA 管电压降低至 100 kV 与显着减少辐射暴露有关，同时保持诊断图像质量。因此，对于经过充分选择的患者，应考虑使用 100 kV 扫描技术来减少 CCTA 剂量。 (J Am Coll Cardiol Img 2009;2:940-6) (C) 2009 年，美国心脏病学会基金会
OBJECTIVES The aim of this study was to determine the impact of a reduced 100-kV tube voltage on image quality and radiation exposure in a pre-defined subgroup analysis of the international, multicenter radiation dose survey PROTECTION I (Prospective Multicenter Study on RadiaTion Dose Estimates Of Cardiac CT AngIOgraphy I) study.BACKGROUND Cardiac computed tomography angiography (CCTA) has become a frequently used diagnostic tool in clinical practice. Despite continually improving CT technology, there remain concerns regarding the associated radiation exposure. A reduced tube voltage of 100 kV has been proposed as an effective means for dose reduction in nonobese patients.METHODS The study assessed the relevant radiation dose parameters as well as quantitative and qualitative diagnostic image quality data in a subgroup of 321 patients (100 kV: 82 patients; 120 kV: 239 patients), who were scanned at study sites that applied a 100-kV tube voltage in at least 1 patient. Diagnostic image quality was assessed by an experienced CCTA investigator with a 4-point score (1: nondiagnostic to 4: excellent image quality). Effective radiation dose was estimated from the dose-length-product of each CCTA study.RESULTS The use of the 100-kV scan protocol was associated with 53% reduction in CCTA median radiation dose estimates, when compared with the conventional 120-kV scan protocol (p < 0.001). Although image noise significantly increased by 26.3% with 100 kV, signal-as well as contrast-to-noise ratios also increased by 7.9% (p = 0.254) and 10.8% (p = 0.027), respectively. Reduction of tube voltage did not impair diagnostic image quality (median diagnostic score: 3.5 [3.25 to 3.75] vs. 3.5 [3.0 to 3.75] for 100 kV vs. 120 kV; p = 0.22). \ CONCLUSIONS In this nonrandomized PROTECTION I dose survey, reducing the CCTA tube voltage to 100 kV in nonobese patients is associated with a significant reduction in radiation exposure while maintaining diagnostic image quality. Thus, the 100-kV scan technique should be considered for CCTA dose reduction in adequately selected patients. (J Am Coll Cardiol Img 2009;2:940-6) (C) 2009 by the American College of Cardiology Foundation