Feasibility of Low-Dose and Low-Contrast Media Volume Approach in Computed Tomography Cardiovascular Imaging Reconstructed with Model-Based Algorithm

• Published in: Tomography (Ann Arbor) Vol. 10; no. 2; pp. 286 - 298
• Main Authors: Ippolito, Davide, Porta, Marco, Maino, Cesare, Riva, Luca, Ragusi, Maria, Giandola, Teresa, Franco, Paolo Niccolò, Cangiotti, Cecilia, Gandola, Davide, De Vito, Andrea, Talei Franzesi, Cammillo, Corso, Rocco
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-02-2024; MDPI
• Subjects: Algorithms; computed tomography angiography; Contrast Media; CT imaging; Diagnostic imaging; Dosage and administration; Feasibility Studies; Humans; model-based iterative reconstruction; Noise control; Radiation; Radiation Dosage; radiation exposure; tomography; Tomography, X-Ray Computed - methods; X-ray computed; transcatheter aortic valve implantation; algorithms; model-based iterative reconstruction; tomography; computed tomography angiography; radiation exposure; X-ray computed
• ISSN: 2379-139X; 2379-1381; 2379-139X
• DOI: 10.3390/tomography10020023

: To evaluate the dose reduction and image quality of low-dose, low-contrast media volume in computed tomography (CT) examinations reconstructed with the model-based iterative reconstruction (MBIR) algorithm in comparison with the hybrid iterative (HIR) one.
We prospectively enrolled a total of 401 patients referred for cardiovascular CT, evaluated with a 256-MDCT scan with a low kVp (80 kVp) reconstructed with an MBIR (study group) or a standard HIR protocol (100 kVp-control group) after injection of a fixed dose of contrast medium volume. Vessel contrast enhancement and image noise were measured by placing the region of interest (ROI) in the left ventricle, ascending aorta; left, right and circumflex coronary arteries; main, right and left pulmonary arteries; aortic arch; and abdominal aorta. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were computed. Subjective image quality obtained by consensus was assessed by using a 4-point Likert scale. Radiation dose exposure was recorded.
HU values of the proximal tract of all coronary arteries; main, right and left pulmonary arteries; and of the aorta were significantly higher in the study group than in the control group (
< 0.05), while the noise was significantly lower (
< 0.05). SNR and CNR values in all anatomic districts were significantly higher in the study group (
< 0.05). MBIR subjective image quality was significantly higher than HIR in CCTA and CTPA protocols (
< 0.05). Radiation dose was significantly lower in the study group (
< 0.05).
The MBIR algorithm combined with low-kVp can help reduce radiation dose exposure, reduce noise, and increase objective and subjective image quality.