Investigating the Effects of the kV Assist Technique on Image Quality and the Reduction of Effective Dose and Carcinogenic Risk of Coronary Computed Tomography Angiography

Document Type : Original Article (s)

10.22122/jims.v39i610.13449

Abstract

Background: The aim of this study was to evaluate the effects of the kV Assist technique on the radiation dose and image quality of coronary computed tomography angiography (CCTA).
Methods: In this retrospective case-control study, 179 patients with the mean age of 58.45±11.86 years, who had undergone CCTA test using the kv assist technique, were considered as the study group; and 141 patients with the mean age of 58.24±11.37 years, who had previously undergone CCTA with the usual 120 kV protocol, were considered as the control group. The two groups were compared in terms of image quality criteria including noise, contrast-to-noise ratio, signal-to-noise ratio, CT numbers of the left coronary artery, and left ventricular chamber, and radiation dose criteria including effective dose and carcinogenic risk.
Results: The effective dose (5.05 ± 2.16 vs. 6.63 ± 3.04 mSv; P < 0.001) and overall risk of carcinogenesis (3.89 ± 1.63 vs. 5.11 ± 2.71 in 10,000 people; P < 0.001) reduced by about 23%in the study group compared to the control group. No significant differences were observed between the two groups in terms of noise, signal-to-noise ratio, and left coronary artery CT number (P > 0.050). Left ventricular chamber CT number and contrast to noise ratio were higher in the study group than the control group (P < 0.001).
Conclusion: Using the kV Assist technique can reduce the effective dose and the carcinogenic risk of CCTA without loss of image quality.

Keywords

References

Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart Disease and Stroke Statistics-2018 Update: A report from the American Heart Association. Circulation 2018; 137(12): e67-e492.
Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med 2007; 357(22): 2277-84.
Chaparian A, Karimi Zarchi H. Assessment of radiation-induced cancer risk to patients undergoing computed tomography angiography scans. Int J Radiat Res 2018; 16(1): 107-15.
Little MP, Wakeford R, Tawn EJ, Bouffler SD, Berrington de GA. Risks associated with low doses and low dose rates of ionizing radiation: why linearity may be (almost) the best we can do. Radiology 2009; 251(1): 6-12.
Silva AC, Lawder HJ, Hara A, Kujak J, Pavlicek W. Innovations in CT dose reduction strategy: Application of the adaptive statistical iterative reconstruction algorithm. AJR Am J Roentgenol 2010; 194(1): 191-9.
Li M, Feng S, Wu N, Zhang L. Scout-based automated tube potential selection technique (kV Assist) in enhanced chest computed tomography: Effects on radiation exposure and image quality. J Comput Assist Tomogr 2017; 41(3): 442-5.
Pflederer T, Jakstat J, Marwan M, Schepis T, Bachmann S, Kuettner A, et al. Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: A randomized comparison. Eur Radiol 2010; 20(5): 1197-206.
LaBounty TM, Leipsic J, Poulter R, Wood D, Johnson M, Srichai MB, et al. Coronary CT angiography of patients with a normal body mass index using 80 kVp versus 100 kVp: A prospective, multicenter, multivendor randomized trial. AJR Am J Roentgenol 2011; 197(5): W860-W867.
Blankstein R, Bolen MA, Pale R, Murphy MK, Shah AB, Bezerra HG, et al. Use of 100 kV versus 120 kV in cardiac dual source computed tomography: effect on radiation dose and image quality. Int J Cardiovasc Imaging 2011; 27(4): 579-86.
Eller A, May MS, Scharf M, Schmid A, Kuefner M, Uder M, et al. Attenuation-based automatic kilovolt selection in abdominal computed tomography: Effects on radiation exposure and image quality. Invest Radiol 2012; 47(10): 559-65.
Eller A, Wuest W, Kramer M, May M, Schmid A, Uder M, et al. Carotid CTA: Radiation exposure and image quality with the use of attenuation-based, automated kilovolt selection. AJNR Am J Neuroradiol 2014; 35(2): 237-41.
Winklehner A, Goetti R, Baumueller S, Karlo C, Schmidt B, Raupach R, et al. Automated attenuation-based tube potential selection for thoracoabdominal computed tomography angiography: Improved dose effectiveness. Invest Radiol 2011; 46(12): 767-73.
Ghadimi P, Chaparian A, Mahmoodi M, Bagheri J. Influences of adaptive statistical iterative reconstruction on image quality and dose reduction in coronary computed tomography angiography. J Isfahan Med Sch 2020; 37(553): 1286-93. [In Persian].
Chen W, Kolditz D, Beister M, Bohle R, Kalender WA. Fast on-site Monte Carlo tool for dose calculations in CT applications. Med Phys 2012; 39(6): 2985-96.
Deak P, van Straten M, Shrimpton PC, Zankl M, Kalender WA. Validation of a Monte Carlo tool for patient-specific dose simulations in multi-slice computed tomography. Eur Radiol 2008; 18(4): 759-72.
Mahmoodi M, Chaparian A. Organ doses, effective dose, and cancer risk from coronary CT angiography examinations. AJR Am J Roentgenol 2020; 214(5): 1131-6.
Karimizarchi H, Chaparian A. Estimating risk of exposure induced cancer death in patients undergoing computed tomography pulmonary angiography. Radioprotection 2017; 52(2): 81-6.
Streffer C. The ICRP 2007 recommendations. Radiat Prot Dosimetry 2007; 127(1-4): 2-7.
Tapiovaara M, Siiskonen T. PCXMC. A Monte Carlo program for calculating patient doses in medical x-ray examinations. STUK-A231. Helsinki, Finland: Stuk; 2008.
National Research Council (U.S.). Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Washington, DC: National Academies Press; 2006.
Hausleiter J, Martinoff S, Hadamitzky M, Martuscelli E, Pschierer I, Feuchtner GM, et al. Image quality and radiation exposure with a low tube voltage protocol for coronary CT angiography results of the PROTECTION II Trial. JACC Cardiovasc Imaging 2010; 3(11): 1113-23.
Journal of Isfahan Medical School
Volume 39, Issue 610
2021
Pages 20-26

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History

  • Receive Date: 01 April 2022
  • Accept Date: 01 April 2022

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