Prospective Randomized Trial on Radiation Dose Estimates of CT Angiography Applying Iterative Image Reconstruction The PROTECTION V Study

被引：45

作者：

Deseive, Simon ^{[1
,2
]}

Chen, Marcus Y. ^{[3
]}

Korosoglou, Grigorios ^{[4
]}

Leipsic, Jonathon ^{[5
]}

Martuscelli, Eugenio ^{[6
,7
]}

Carrascosa, Patricia ^{[8
]}

Mirsadraee, Saeed ^{[9
]}

White, Charles ^{[10
]}

Hadamitzky, Martin ^{[2
]}

Martinoff, Stefan ^{[2
]}

Menges, Anna-Leonie ^{[1
,2
]}

Bischoff, Bernhard ^{[11
]}

Massberg, Steffen ^{[1
,2
]}

Hausleiter, Joerg ^{[1
,2
]}

机构：

[1] Univ Munich, Med Klin & Poliklin 1, D-81377 Munich, Germany

[2] Tech Univ Munich, Deutsch Herzzentrum Munchen, Klin, Inst Radiol & Nukl Med, D-80290 Munich, Germany

[3] NIH, Bethesda, MD 20892 USA

[4] Univ Klinikum Heidelberg, Klin Innere Med 3, Heidelberg, Germany

[5] Univ British Columbia, Dept Radiol, St Pauls Hosp, Vancouver, BC, Canada

[6] Univ Roma Tor Vergata, Dept Internal Med, Rome, Italy

[7] Clin Paideia, Rome, Italy

[8] Dept Tomog Computada & Invest Diagnost Maipu, Buenos Aires, DF, Argentina

[9] Univ Edinburgh, Dept Radiol, Edinburgh, Midlothian, Scotland

[10] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[11] Univ Munich, Inst Klin Radiol, D-81377 Munich, Germany

来源：

JACC-CARDIOVASCULAR IMAGING | 2015年 / 8卷 / 08期

关键词：

computed tomography angiography; coronary; iterative image reconstruction; radiation dose; FILTERED BACK-PROJECTION; COMPUTED-TOMOGRAPHY ANGIOGRAPHY; DIAGNOSTIC-ACCURACY; QUALITY; EXPOSURE;

D O I：

10.1016/j.jcmg.2015.02.024

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES The purpose of this study was to assess the potential of iterative image reconstruction (IR) of images for radiation dose reduction in coronary computed tomography angiography (CIA). Therefore, IR in combination with 30% tube current reduction was compared with standard scanning with filtered back projection (FBP) reconstruction. BACKGROUND Lately, new IR techniques with advanced raw data processing have been introduced by different computed tomography vendors, thus allowing for either image noise reduction at unchanged radiation dose levels or radiation dose reductions at comparable image noise levels. METHODS In this prospective, multicenter, multivendor noninferiority trial, we randomized 400 consecutive patients to 1 of 2 groups: a control group using standard FBP image reconstruction and standard tube current or an interventional group using IR technique and 30% tube current reduction. The primary endpoint was to demonstrate noninferiority in image quality (IQ) in the IR group. IQ was assessed on a 4-point scale (1, nondiagnostic IQ; 4, excellent IQ). Secondary endpoints included total radiation dose estimates and the rate of downstream testing during 30-day follow-up. RESULTS Median IQ in the IR group was noninferior compared with the conventional FBP group (IR, 3.5 [interquartile range: 3.0 to 4.0]; FBP, 3.4 [interquartile range: 2.8 to 4.0], p for noninferiority <0.016). The radiation exposure was significantly lower in the IR group (median dose-length-product 157 [interquartile range: 114 to 239] mGy.cm vs. 222 [interquartile range: 141 to 319] mGy.cm for IR vs. FBP, respectively, p < 0.0001). The rate of downstream testing did not differ significantly (7.7% vs. 7.9% for IR vs. FBP, respectively, p = 0.94). CONCLUSIONS Coronary CTA image quality is maintained with the combined use of a 30% reduced tube current and IR algorithms when compared with conventional FBP image reconstruction techniques and standard tube current. (C) 2015 by the American College of Cardiology Foundation.

引用

页码：888 / 896

页数：9

共 27 条

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