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Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans

PURPOSE: To identify the optimum strength of advanced modeled iterative reconstruction (ADMIRE) to achieve the best subjective and objective image quality when combining three-dose reduction strategies, ultra-high-pitch computed tomography coronary angiography (FLASH CTCA; with single-dose ivabradin...

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Autores principales: Kumari, Nidhi, Ganga, Kartik P., Ojha, Vineeta, Kumar, Sanjeev, Jagia, Priya, Naik, Nitish, Gulati, Gurpreet, Sharma, Sanjiv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679714/
https://www.ncbi.nlm.nih.gov/pubmed/36987879
http://dx.doi.org/10.4274/dir.2021.0849
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author Kumari, Nidhi
Ganga, Kartik P.
Ojha, Vineeta
Kumar, Sanjeev
Jagia, Priya
Naik, Nitish
Gulati, Gurpreet
Sharma, Sanjiv
author_facet Kumari, Nidhi
Ganga, Kartik P.
Ojha, Vineeta
Kumar, Sanjeev
Jagia, Priya
Naik, Nitish
Gulati, Gurpreet
Sharma, Sanjiv
author_sort Kumari, Nidhi
collection PubMed
description PURPOSE: To identify the optimum strength of advanced modeled iterative reconstruction (ADMIRE) to achieve the best subjective and objective image quality when combining three-dose reduction strategies, ultra-high-pitch computed tomography coronary angiography (FLASH CTCA; with single-dose ivabradine to lower heart rate), low tube voltage, and ADMIRE. METHODS: Sixty consecutive patients underwent FLASH CTCA at 100 kVp in this single-center prospective study. Single-dose ivabradine was administered to patients whose heart rate was above 75 bpm. Images were reconstructed using the three highest strengths of ADMIRE (A3, A4, and A5). Objective and subjective image quality (using a Likert scale) were evaluated in the three datasets. RESULTS: The signal strength remained unchanged but mean noise significantly reduced across the increasing strengths of ADMIRE [signal: 513.78 ± 101.7 Hounsfield units (HU) at A3, 515.6 ± 100.5 HU at A4, and 519.7 ± 107.9 HU at A5; noise: 23.4 ± 4.5 HU at A3, 20.2 ± 3.6 HU at A4, and 17.2 ± 3.3 HU at A5]. Signal-to-noise and contrast-to-noise ratios were the highest at A5, and A5 offered significantly higher Likert scores in image noise, vessel sharpness, and overall image quality than A3 or A4. Additionally, A5 did not interfere with image interpretation in any patient. CONCLUSION: Using all three dose reduction strategies during FLASH CTCA along with single-dose ivabradine administration ensures minimal radiation exposure in daily practice. In this study, A5 datasets had the best overall subjective and objective image quality despite their “plastic appearance”. In the future, enhanced dose reduction can be obtained by further lowering tube voltages.
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spelling pubmed-106797142023-12-05 Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans Kumari, Nidhi Ganga, Kartik P. Ojha, Vineeta Kumar, Sanjeev Jagia, Priya Naik, Nitish Gulati, Gurpreet Sharma, Sanjiv Diagn Interv Radiol Cardiovascular Imaging - Original Article PURPOSE: To identify the optimum strength of advanced modeled iterative reconstruction (ADMIRE) to achieve the best subjective and objective image quality when combining three-dose reduction strategies, ultra-high-pitch computed tomography coronary angiography (FLASH CTCA; with single-dose ivabradine to lower heart rate), low tube voltage, and ADMIRE. METHODS: Sixty consecutive patients underwent FLASH CTCA at 100 kVp in this single-center prospective study. Single-dose ivabradine was administered to patients whose heart rate was above 75 bpm. Images were reconstructed using the three highest strengths of ADMIRE (A3, A4, and A5). Objective and subjective image quality (using a Likert scale) were evaluated in the three datasets. RESULTS: The signal strength remained unchanged but mean noise significantly reduced across the increasing strengths of ADMIRE [signal: 513.78 ± 101.7 Hounsfield units (HU) at A3, 515.6 ± 100.5 HU at A4, and 519.7 ± 107.9 HU at A5; noise: 23.4 ± 4.5 HU at A3, 20.2 ± 3.6 HU at A4, and 17.2 ± 3.3 HU at A5]. Signal-to-noise and contrast-to-noise ratios were the highest at A5, and A5 offered significantly higher Likert scores in image noise, vessel sharpness, and overall image quality than A3 or A4. Additionally, A5 did not interfere with image interpretation in any patient. CONCLUSION: Using all three dose reduction strategies during FLASH CTCA along with single-dose ivabradine administration ensures minimal radiation exposure in daily practice. In this study, A5 datasets had the best overall subjective and objective image quality despite their “plastic appearance”. In the future, enhanced dose reduction can be obtained by further lowering tube voltages. Galenos Publishing 2023-03-29 /pmc/articles/PMC10679714/ /pubmed/36987879 http://dx.doi.org/10.4274/dir.2021.0849 Text en © Copyright 2023 by Turkish Society of Radiology | Diagnostic and Interventional Radiology, published by Galenos Publishing House. https://creativecommons.org/licenses/by-nc/4.0/Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Cardiovascular Imaging - Original Article
Kumari, Nidhi
Ganga, Kartik P.
Ojha, Vineeta
Kumar, Sanjeev
Jagia, Priya
Naik, Nitish
Gulati, Gurpreet
Sharma, Sanjiv
Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title_full Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title_fullStr Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title_full_unstemmed Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title_short Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
title_sort low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans
topic Cardiovascular Imaging - Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679714/
https://www.ncbi.nlm.nih.gov/pubmed/36987879
http://dx.doi.org/10.4274/dir.2021.0849
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