Direct chest area measurement: A potential anthropometric replacement for BMI to inform cardiac CT dose parameters?

详细信息    查看全文

• 作者：Brian B. Ghoshhajra ; MD ; MBA^a ; ^&dagger ; ; Leif-Christopher Engel ; MD^a ; ^&dagger ; ; ^{lengel@partners.org} ; Gyö ; ngyi Petra Major^b ; Dan Verdini ; MD^b ; Manavjot Sidhu ; MD^b ; Mihá ; ly Ká ; rolyi ; MD^b ; Suhny Abbara ; MD^b ; Udo Hoffmann ; MD ; MPH^b ; Manudeep Kalra ; MD^b ; Thomas J. Brady ; MD^b
• 关键词：Radiation dose ; Cardiac CT angiography ; Tube voltage ; Contrast-to-noise ratio ; Image quality ; Linear regression ; Second-generation dual-source CT
• 刊名：Journal of Cardiovascular Computed Tomography
• 出版年：2011
• 出版时间：July-August 2011
• 年：2011
• 卷：5
• 期：4
• 页码：240-246
• 全文大小：455 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background

Significant dose reductions for coronary CT angiography (CTA) can be achieved with reduced tube potential (kV); however, the potential effect on image quality is unknown.

Objective

We sought to evaluate anthropometric measures (chest area, chest circumference, and chest attenuation) as potentially better predictors of the appropriate tube potential versus body mass index (BMI).

Methods

Consecutive patients (n = 183) who underwent routine coronary CTA (with standard department protocols, whereby tube potential was selected according to BMI) between April 2010 and October 2010 were included. All anthropometric measures were obtained by tracing a region of interest encompassing an entire axial full field-of-view image at the mid left atrial level. Linear regression was used to stratify patients into 4 chest area classes (very small to large). Patients were also stratified by standard BMI classes (underweight to obese). Qualitative and quantitative image quality parameters were compared between concordant and discordant chest area and BMI classes.

Results

A strong correlation was observed between patients?BMI and chest area (r = 0.84; P < 0.001) and between BMI and chest circumference (r = 0.82, P < 0.001). Concordance between chest area class and BMI class was found in 61 % , whereas 17.6 % of patients were ¡°potentially underdosed?(chest area class > BMI class) and 21.4 % were ¡°potentially overdosed?(chest area class < BMI class). Signal and contrast of the proximal coronaries and left ventricle were significantly different between the groups.

Conclusion

Patients?chest area and BMI classes were frequently discordant, potentially leading to overdosing or underdosing when using BMI to select tube potential.