The Impact of Combining a Low-Tube Voltage Acquisition with Iterative Reconstruction on Total Iodine Dose in Coronary CT Angiography

Abstract EN

Objectives.

To assess the impact of combining low-tube voltage acquisition with iterative reconstruction (IR) techniques on the iodine dose in coronary CTA.

Methods.

Three minipigs underwent CCTA to compare a standard of care protocol with two alternative study protocols combining low-tube voltage and low iodine dose with IR.

Image quality was evaluated objectively by the CT value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the main coronary arteries and aorta and subjectively by expert reading.

Statistics were performed by Mann–Whitney U test and Chi-square analysis.

Results.

Despite reduced iodine dose, both study protocols maintained CT values, SNR, and CNR compared to the standard of care protocol.

Expert readings confirmed these findings; all scans were perceived to be of at least diagnostically acceptable quality on all evaluated parameters allowing image interpretation.

No statistical differences were observed (all p values > 0.11), except for streak artifacts (p=0.02) which were considered to be more severe, although acceptable, with the 80 kVp protocol.

Conclusions.

Reduced tube voltage in combination with IR allows a total iodine dose reduction between 37 and 50%, by using contrast media with low iodine concentrations of 200 and 160 mg I/mL, while maintaining image quality.