The Impact of Different Levels of Adaptive Iterative Dose Reduction 3D on Image Quality of 320-Row Coronary CT Angiography: A Clinical Trial

Sarah Feger; Matthias Rief; Elke Zimmermann; Peter Martus; Joanne Désirée Schuijf; Jörg Blobel; Felicitas Richter; Marc Dewey

doi:10.1371/journal.pone.0125943

The Impact of Different Levels of Adaptive Iterative Dose Reduction 3D on Image Quality of 320-Row Coronary CT Angiography: A Clinical Trial

PLoS One. 2015 May 6;10(5):e0125943. doi: 10.1371/journal.pone.0125943. eCollection 2015.

Authors

Sarah Feger¹, Matthias Rief¹, Elke Zimmermann¹, Peter Martus², Joanne Désirée Schuijf³, Jörg Blobel³, Felicitas Richter⁴, Marc Dewey¹

Affiliations

¹ Department of Radiology, Charité Medical School, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.
² Department of Radiology, Charité Medical School, Berlin, Germany.
³ Toshiba Medical Systems Europe B.V., Zoetermeer, the Netherlands.
⁴ Department of Radiology, Charité Medical School, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany; Department of Medical Statistics, Informatics and Documentation, University Hospital of Friedrich-Schiller University Jena, Jena, Germany.

Abstract

Purpose: The aim of this study was the systematic image quality evaluation of coronary CT angiography (CTA), reconstructed with the 3 different levels of adaptive iterative dose reduction (AIDR 3D) and compared to filtered back projection (FBP) with quantum denoising software (QDS).

Methods: Standard-dose CTA raw data of 30 patients with mean radiation dose of 3.2 ± 2.6 mSv were reconstructed using AIDR 3D mild, standard, strong and compared to FBP/QDS. Objective image quality comparison (signal, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contour sharpness) was performed using 21 measurement points per patient, including measurements in each coronary artery from proximal to distal.

Results: Objective image quality parameters improved with increasing levels of AIDR 3D. Noise was lowest in AIDR 3D strong (p ≤ 0.001 at 20/21 measurement points; compared with FBP/QDS). Signal and contour sharpness analysis showed no significant difference between the reconstruction algorithms for most measurement points. Best coronary SNR and CNR were achieved with AIDR 3D strong. No loss of SNR or CNR in distal segments was seen with AIDR 3D as compared to FBP.

Conclusions: On standard-dose coronary CTA images, AIDR 3D strong showed higher objective image quality than FBP/QDS without reducing contour sharpness.

Trial registration: Clinicaltrials.gov NCT00967876.

Publication types

Clinical Trial
Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Algorithms
Contrast Media
Coronary Angiography / methods*
Coronary Vessels / diagnostic imaging*
Coronary Vessels / surgery
Female
Humans
Male
Middle Aged
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted / methods*
Signal-To-Noise Ratio
Stents
Tomography, X-Ray Computed / methods*

Substances

Contrast Media

Associated data

ClinicalTrials.gov/NCT00967876

Grants and funding

The authors of this manuscript declare relationships with the following companies: Prof. Dewey has received grant support from the Heisenberg Program of the DFG for a professorship (DE 1361/14-1), the FP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), the European Regional Development Fund (20072013 2/05, 20072013 2/48), the German Heart Foundation/German Foundation of Heart Research (F/23/08, F/27/10), the Joint Program from the German Research Foundation (DFG) and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110), GE Healthcare, Bracco, Guerbet, and Toshiba Medical Systems. The CARS-320 study has received grants from Bracco. Prof. Dewey has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin, and Bayer (Schering-Berlex). Prof. Dewey is a consultant to Guerbet and one of the principal investigators of multi-center studies (CORE-64 and 320) on coronary CT angiography sponsored by Toshiba Medical Systems. He is also the editor of Coronary CT Angiography and Cardiac CT, both published by Springer, and offers hands-on workshops on cardiovascular imaging (www.ct-kurs.de). Prof. Dewey is an associate editor of Radiology and European Radiology. Dr. Jörg Blobel and Dr. Joanne Schuijf are full-time employees of Toshiba Medical Systems Europe. Institutional master research agreements exist with Siemens Medical Solutions, Philips Medical Systems, and Toshiba Medical Systems. The terms of these arrangements are managed by the legal department of Charité – Universitätsmedizin Berlin. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors have full control control of all primary data. All funders (TMS, Guerbet, CMR Bayer, Siemens) provided support in form of salaries, but did not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the “author contributions`section”.