CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study)

Kavitha M. Chinnaiyan, Abhay N. Bilolikar, Edward Walsh, Daniel Wood, Ann DePetris, Ralph Gentry, Judith Boura, Suhny Abbara, Mouaz Al-Mallah, Kostaki Bis, Gilbert Boswell, Michael Gallagher, Ing Orn Arunakul, Sandra Halliburton, Jill Jacobs, John Lesser, U. Joseph Schoepf, Uma S. Valeti, Gilbert L. Raff

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: To establish current radiation dose levels with contemporary scanners capable of prospectively triggered or high-pitch spiral scan modes to previous generation scanners among patients evaluated for coronary artery disease, pulmonary embolism, aortic disease, and "triple rule out" in a large population of patients at multiple centers. Background: Previous small-scale studies with carefully controlled scan protocols report that CT scanners that facilitate prospectively triggered scanning and provide high-pitch spiral CT scan modes drastically lower radiation doses. However, diagnostic reference levels should be selected by medical bodies on the basis of large surveys of representative sites and reviewed at appropriate time intervals. Methods: Scan data including dose and image quality parameters were collected retrospectively from 64 slice scanners (control) and prospectively after sites installed 128-slice dual-source scanners with high-pitch capability (study). Protocol selection was purposely not specified to survey "real world" results. Blinded quantitative image analysis was performed on every fifth scan. Results: From April 2011 to March 2012, 2085 patients at 9 sites completed the study: 1051 coronary artery disease (509 control, 542 study), 528 pulmonary embolism (267 control, 261 study), 419 aortic disease (268 control, 151 study), and 87 triple rule out (53 control, 34 study). There was a significant reduction in median dose-length product (DLP) from 669mGy{bullet operator}cm (interquartile range [IQR]: 419-1026mGy{bullet operator}cm) in the control group to 260mGy{bullet operator}cm (IQR: 159-441mGy{bullet operator}cm) in the study group, a reduction by 61% (P < .0001) and was lower in all categories. No significant differences were noted in image quality. Conclusion: Use of advanced scanners facilitating prospectively triggered or high-pitch spiral scan modes results in marked dose reduction across a variety of cardiovascular studies, with no compromise in image quality. These findings may contribute to new target dose recommendations in societal guidelines.

Original languageEnglish (US)
Pages (from-to)205-214
Number of pages10
JournalJournal of Cardiovascular Computed Tomography
Volume8
Issue number3
DOIs
StatePublished - 2014

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Aortic Diseases
Pulmonary Embolism
Coronary Artery Disease
Radiation
Spiral Computed Tomography
Guidelines
Control Groups
Population
Surveys and Questionnaires
CT protocol

Keywords

  • DLP
  • Dose recommendation
  • High-pitch
  • Prospective-triggered
  • Radiation dose reduction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study). / Chinnaiyan, Kavitha M.; Bilolikar, Abhay N.; Walsh, Edward; Wood, Daniel; DePetris, Ann; Gentry, Ralph; Boura, Judith; Abbara, Suhny; Al-Mallah, Mouaz; Bis, Kostaki; Boswell, Gilbert; Gallagher, Michael; Arunakul, Ing Orn; Halliburton, Sandra; Jacobs, Jill; Lesser, John; Schoepf, U. Joseph; Valeti, Uma S.; Raff, Gilbert L.

In: Journal of Cardiovascular Computed Tomography, Vol. 8, No. 3, 2014, p. 205-214.

Research output: Contribution to journalArticle

Chinnaiyan, KM, Bilolikar, AN, Walsh, E, Wood, D, DePetris, A, Gentry, R, Boura, J, Abbara, S, Al-Mallah, M, Bis, K, Boswell, G, Gallagher, M, Arunakul, IO, Halliburton, S, Jacobs, J, Lesser, J, Schoepf, UJ, Valeti, US & Raff, GL 2014, 'CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study)', Journal of Cardiovascular Computed Tomography, vol. 8, no. 3, pp. 205-214. https://doi.org/10.1016/j.jcct.2014.04.001
Chinnaiyan, Kavitha M. ; Bilolikar, Abhay N. ; Walsh, Edward ; Wood, Daniel ; DePetris, Ann ; Gentry, Ralph ; Boura, Judith ; Abbara, Suhny ; Al-Mallah, Mouaz ; Bis, Kostaki ; Boswell, Gilbert ; Gallagher, Michael ; Arunakul, Ing Orn ; Halliburton, Sandra ; Jacobs, Jill ; Lesser, John ; Schoepf, U. Joseph ; Valeti, Uma S. ; Raff, Gilbert L. / CT dose reduction using prospectively triggered or fast-pitch spiral technique employed in cardiothoracic imaging (the CT dose study). In: Journal of Cardiovascular Computed Tomography. 2014 ; Vol. 8, No. 3. pp. 205-214.
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AU - Chinnaiyan, Kavitha M.

AU - Bilolikar, Abhay N.

AU - Walsh, Edward

AU - Wood, Daniel

AU - DePetris, Ann

AU - Gentry, Ralph

AU - Boura, Judith

AU - Abbara, Suhny

AU - Al-Mallah, Mouaz

AU - Bis, Kostaki

AU - Boswell, Gilbert

AU - Gallagher, Michael

AU - Arunakul, Ing Orn

AU - Halliburton, Sandra

AU - Jacobs, Jill

AU - Lesser, John

AU - Schoepf, U. Joseph

AU - Valeti, Uma S.

AU - Raff, Gilbert L.

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KW - DLP

KW - Dose recommendation

KW - High-pitch

KW - Prospective-triggered

KW - Radiation dose reduction

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