To estimate the radiation dose of CTCA in clinical practice and evaluate the effect of dose-saving algorithms on radiation dose and image quality.
Effective radiation dose was measured from the dose-length product in 616 consecutive patients (mean age 58 卤 12 years; 70%males) who underwent clinically indicated CTCA at our institution over 1 year. Image quality was assessed subjectively using a 4-point scale and objectively by measuring the signal- and contrast-to-noise ratios in the coronary arteries. Multivariate linear regression analysis was used to identify factors independently associated with radiation dose.
Mean effective radiation dose of CTCA was 6.6 卤 3.3 mSv. Radiation dose was significantly reduced by dose saving algorithms such as 100 kV imaging (鈭?7%; 95%CI, 鈭?4%to 鈭?0%), prospective gating (鈭?5%; 95%CI, 鈭?9%to 鈭?0%) and ECG controlled tube current modulation (鈭?3%; 95%CI, 鈭?%to 鈭?4%). None of the dose saving algorithms were associated with a significant reduction in mean image quality or the frequency of diagnostic scans (P = non-significant for all comparisons).
Careful application of radiation-dose saving algorithms in appropriately selected patients can reduce the radiation burden of CTCA significantly, without compromising the image quality.