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Diagnostics
Volume 11
Issue 12
10.3390/diagnostics11122192
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Article

Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source Photon-Counting CT Data: A Dynamic Phantom Study

by
Niels R. van der Werf
1,*,†,
Margo van Gent
2,†,
Ronald Booij
1,
Daniel Bos
1,
Aad van der Lugt
1,
Ricardo P. J. Budde
1,
Marcel J. W. Greuter
2,3 and
Marcel van Straten
1
1
Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
2
Department of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
3
Department of Robotics and Mechatronics, University of Twente, 7522 NB Enschede, The Netherlands
*
Author to whom correspondence should be addressed.
†
Authors contributed equally.
Diagnostics 2021, 11(12), 2192; https://doi.org/10.3390/diagnostics11122192
Submission received: 28 October 2021 / Revised: 17 November 2021 / Accepted: 21 November 2021 / Published: 25 November 2021
(This article belongs to the Special Issue Advances in Photon Counting Detector Imaging)
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Abstract

In order to assess coronary artery calcium (CAC) quantification reproducibility for photon-counting computed tomography (PCCT) at reduced tube potential, an anthropomorphic thorax phantom with low-, medium-, and high-density CAC inserts was scanned with PCCT (NAEOTOM Alpha, Siemens Healthineers) at two heart rates: 0 and 60–75 beats per minute (bpm). Five imaging protocols were used: 120 kVp standard dose (IQ level 16, reference), 90 kVp at standard (IQ level 16), 75% and 45% dose and tin-filtered 100 kVp at standard dose (IQ level 16). Each scan was repeated five times. Images were reconstructed using monoE reconstruction at 70 keV. For each heart rate, CAC values, quantified as Agatston scores, were compared with the reference, whereby deviations >10% were deemed clinically relevant. Reference protocol radiation dose (as volumetric CT dose index) was 4.06 mGy. Radiation dose was reduced by 27%, 44%, 67%, and 46% for the 90 kVp standard dose, 90 kVp 75% dose, 90 kVp 45% dose, and Sn100 standard dose protocol, respectively. For the low-density CAC, all reduced tube current protocols resulted in clinically relevant differences with the reference. For the medium- and high-density CAC, the implemented 90 kVp protocols and heart rates revealed no clinically relevant differences in Agatston score based on 95% confidence intervals. In conclusion, PCCT allows for reproducible Agatston scores at a reduced tube voltage of 90 kVp with radiation dose reductions up to 67% for medium- and high-density CAC.
Keywords: X-ray computed tomography; calcium; coronary vessels; imaging phantoms; photon counting detector; radiation dose; image quality X-ray computed tomography; calcium; coronary vessels; imaging phantoms; photon counting detector; radiation dose; image quality

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MDPI and ACS Style

van der Werf, N.R.; van Gent, M.; Booij, R.; Bos, D.; van der Lugt, A.; Budde, R.P.J.; Greuter, M.J.W.; van Straten, M. Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source Photon-Counting CT Data: A Dynamic Phantom Study. Diagnostics 2021, 11, 2192. https://doi.org/10.3390/diagnostics11122192

AMA Style

van der Werf NR, van Gent M, Booij R, Bos D, van der Lugt A, Budde RPJ, Greuter MJW, van Straten M. Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source Photon-Counting CT Data: A Dynamic Phantom Study. Diagnostics. 2021; 11(12):2192. https://doi.org/10.3390/diagnostics11122192

Chicago/Turabian Style

van der Werf, Niels R., Margo van Gent, Ronald Booij, Daniel Bos, Aad van der Lugt, Ricardo P. J. Budde, Marcel J. W. Greuter, and Marcel van Straten. 2021. "Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source Photon-Counting CT Data: A Dynamic Phantom Study" Diagnostics 11, no. 12: 2192. https://doi.org/10.3390/diagnostics11122192

APA Style

van der Werf, N. R., van Gent, M., Booij, R., Bos, D., van der Lugt, A., Budde, R. P. J., Greuter, M. J. W., & van Straten, M. (2021). Dose Reduction in Coronary Artery Calcium Scoring Using Mono-Energetic Images from Reduced Tube Voltage Dual-Source Photon-Counting CT Data: A Dynamic Phantom Study. Diagnostics, 11(12), 2192. https://doi.org/10.3390/diagnostics11122192

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