The impact of combining low tube voltage scanning with iterative reconstruction on total iodine dose in coronary CT angiography.

Research output: Chapter in Book/Report/Conference proceedingMeeting abstract (Book)


Purpose: To assess the impact of combining low-tube voltages and iterative reconstruction (IR) on contrast dose in coronary CTA.

Methods and Materials: A standard of care (SoC) 120kVp scan with 320mgI/ml iodine based contrast (Visipaque, GE Healthcare) and FBP reconstruction was compared with two study protocols: 80kVp with 160mgI/ml (protocol A) and 100kVp with 200mgI/ml (protocol B), both reconstructed with IR (ASiR). Each protocol was scanned (Discovery) three times on two minipigs (Ellegaard) with constant injection protocol (speed 3ml/s, volume 1.5ml/kg) and radiation dose. Quantitative image quality was evaluated by CT-value and signal-to-noise ratio (SNR) of the right coronary artery (RCA), left anterior descending coronary (LAD) and left circumflex artery (LCx). Expert readers performed qualitative assessment for overall quality, vessel sharpness, noise and streak artifacts.

Results: Despite reduced iodine load, both study protocols did not yield inferior CT-value and SNR for all arteries. For RCA, the mean SoC signal (307HU) was preserved with protocol A (273HU, p=0.15) and B (258HU, p=0.08). Also the SNR was non inferior from SoC (SNR=7.0) with A (8.1, p=0.75) and B (8.7, p=0.57). All scans were perceived to be of at least acceptable quality on all evaluated parameters allowing diagnostic interpretation. No statistical differences were observed (all p-values>0.12), except for streak artifacts (p=0.01) who were considered to be more severe, although acceptable, with protocol A.

Conclusion: The use of a reduced tube voltage combined with iterative reconstruction allows a marked reduction in iodine dose up to a factor of two without impairing image quality.
Original languageEnglish
Title of host publicationEuropean Congress of Radiology (ECR), Vienna, March
Publication statusPublished - Mar 2014
EventEuropean Congress of Radiology, ECR 2014 - Vienna, Austria
Duration: 6 Mar 201410 Mar 2014


ConferenceEuropean Congress of Radiology, ECR 2014


  • Contrast media
  • Iodine dose reduction
  • Coronary CT aniography


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