| Di Aihui,Ning Chunfang,Wang Ying,Li Jing,Han Jintao,Zhang Yan.Feasibility of low radiation dose and low contrast dose for coronary CT angiography in obese patients[J].Chinese Journal of Radiological Medicine and Protection,2024,44(1):41-46 |
| Feasibility of low radiation dose and low contrast dose for coronary CT angiography in obese patients |
| Received:June 09, 2023 |
| DOI：10.3760/cma.j.cn112271-20230609-00188 |
| KeyWords:Coronary CT angiography Obesity Low radiation dose Iodine delivery rate Low contrast dosage |
| FundProject: |
| Author Name | Affiliation | E-mail | | Di Aihui | Department of Radiology, Peking University Third Hospital, Beijing 100191, China | | | Ning Chunfang | Department of Radiology, Peking University Third Hospital, Beijing 100191, China | | | Wang Ying | Department of Radiology, Peking University Third Hospital, Beijing 100191, China | | | Li Jing | United Imaging Healthcare, Shanghai 201800, China | | | Han Jintao | United Imaging Healthcare, Shanghai 201800, China | | | Zhang Yan | Department of Radiology, Peking University Third Hospital, Beijing 100191, China | zhangyan2216@outlook.com |
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| Abstract:: |
| Objective To evaluate the feasibility of low radiation dose and low contrast dosage in coronary CT angiography (CCTA) of class I obese patients.Methods This prospective study enrolled 57 patients (male/female, 50/7, age, 25-77 years) with body mass index (BMI) of 30-38 kg/m2 and body weight of 85-119 kg scheduled for CCTA from August 2022 to March 2023 in our hospital. The patients were divided into two groups: control group (group A, n = 20) and low-dose group (group B, n= 37). Group A employed a standard-dose protocol: tube voltage 120 kVp and IDR 2.2 g I/s, while group B were scanned using the low-dose protocol: tube voltage 100 kVp and IDR 1.5 g I/s. Images in Group A and Group B were reconstructed with hybrid iterative reconstruction (HIR) at strength 4 and 8, respectively. Other scanning and reconstruction parameters were the same in two groups.Methods The image quality was assessed by measuring the CT values and noise in the aortic root, left anterior descending artery and right coronary artery, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was evaluated for vessels according to the 18-segment classification system using a 4-point scale (1. poor, 4. excellent). The effective dose E and contrast dosage were compared. Statistical analysis was performed using independent samples t-test, Mann-Whitney U test or χ2 test.Results The BMI of groups A and B were 31.89 (30.77, 33.81) and 31.22 (30.46, 32.83) kg/m2, respectively (P>0.05). No statistically significant differences in CT values, noise, SNR, CNR were noticed between the two groups (all P>0.05). The mean subjective score of all coronary artery segments in the two groups were not less than 3, meeting the requirement of clinical diagnosis. There was no statistically significant difference in the overall subjective image quality between the two groups (P>0.05). The radiation dose E in groups A and B were 7.58 and 4.49 mSv, respectively (Z=-5.46, P<0.05). The contrast dosage in groups A and B were 66 and 45 ml, respectively. The radiation dose E and contrast dosage in group B were 41% and 32% lower than that in group A, respectively.Conclusions For class I obese patients, it was feasible to use a low tube voltage (100 kVp) and low IDR (1.5 gI/s) protocol in CCTA. Radiation dose and contrast dosage can be reduced reasonably without compromising the CCTA image quality. |
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