ABSTRACT
PURPOSE: The aim of the study was to estimate radiation exposure of coronary calcium scoring and angiography using ECG-gated and ECG-triggered dual-source computed tomography. MATERIALS AND METHODS: An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for all dose measurements. Effective dose was calculated according to ICRP 103. Radiation exposure was performed on a dual-source computed tomography (DSCT) scanner with standard protocols for calcium scoring (DSCT-Ca) and coronary angiography (DSCTA) at different heart rates (40-100 beats/min). Furthermore, a scanning protocol with ECG-triggering as well as a standard chest CT scan were evaluated. RESULTS: Depending on gender, heart rate and ECG-pulsing, the effective dose of a complete cardiac DSCT (DSCT-Ca and DSCTA) scan varies from 10.2 to 32.6mSv. The effective radiation dose increased significantly with lower heart rates (p<0.035). ECG-pulsing reduced the radiation exposure significantly in DSCTA (p<0.001). Due to breast tissue in the primary scan range, females' doses showed an increase up to 69.9% compared to males in scan protocols without ECG-pulsing. Prospective ECG-triggered DSCTA resulted in estimated effective doses from 2.8mSv (males) to 4.1mSv (females). CONCLUSION: The ECG-pulsing technique has proven its effectiveness to reduce effective dose in coronary CT angiography and is recommended for all patients with regular heart rates. The patient's heart rate influences the radiation exposure with a significant decrease at higher heart rates. Due to its lower dose, ECG-triggered DSCTA should be implemented for special indications, i.e. for diagnosis of pathologies of the aortic root and the ascending aorta.
Subject(s)
Body Burden , Cardiac-Gated Imaging Techniques/methods , Coronary Angiography/methods , Radiation Dosage , Radiography, Dual-Energy Scanned Projection/methods , Radiometry/methods , Tomography, X-Ray Computed/methods , Female , Humans , Male , Phantoms, Imaging , Prospective Studies , Retrospective Studies , Sex FactorsABSTRACT
The aim of the study was to evaluate radiation exposure of a chest pain protocol with ECG-gated dual-source computed tomography (DSCT). An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for dose measurements. Exposure was performed on a dual-source computed tomography system with a standard protocol for chest pain evaluation (120 kV, 320 mAs/rot) with different simulated heart rates (HRs). The dose of a standard chest CT examination (120 kV, 160 mAs) was also measured. Effective dose of the chest pain protocol was 19.3/21.9 mSv (male/female, HR 60), 17.9/20.4 mSv (male/female, HR 80) and 14.7/16.7 mSv (male/female, HR 100). Effective dose of a standard chest examination was 6.3 mSv (males) and 7.2 mSv (females). Radiation dose of the chest pain protocol increases significantly with a lower heart rate for both males (p = 0.040) and females (p = 0.044). The average radiation dose of a standard chest CT examination is about 36.5% that of a CT examination performed for chest pain. Using DSCT, the evaluated chest pain protocol revealed a higher radiation exposure compared with standard chest CT. Furthermore, HRs markedly influenced the dose exposure when using the ECG-gated chest pain protocol.
