van der Werf N R, Willemink M J, Willems T P, Greuter M J W, Leiner T
Department of Radiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Int J Cardiovasc Imaging. 2017 Jun;33(6):899-914. doi: 10.1007/s10554-017-1061-y. Epub 2017 Jan 19.
To evaluate the influence of dose reduction in combination with iterative reconstruction (IR) on coronary calcium scores (CCS) in a dynamic phantom on state-of-the-art CT systems from different manufacturers. Calcified inserts in an anthropomorphic chest phantom were translated at 20 mm/s corresponding to heart rates between 60 and 75 bpm. The inserts were scanned five times with routinely used CCS protocols at reference dose and 40 and 80% dose reduction on four high-end CT systems. Filtered back projection (FBP) and increasing levels of IR were applied. Noise levels were determined. CCS, quantified as Agatston and mass scores, were compared to physical mass and scores at FBP reference dose. For the reference dose in combination with FBP, noise level variation between CT systems was less than 18%. Decreasing dose almost always resulted in increased CCS, while at increased levels of IR, CCS decreased again. The influence of IR on CCS was smaller than the influence of dose reduction. At reference dose, physical mass was underestimated 3-30%. All CT systems showed similar CCS at 40% dose reduction in combinations with specific reconstructions. For some CT systems CCS was not affected at 80% dose reduction, in combination with IR. This multivendor study showed that radiation dose reductions of 40% did not influence CCS in a dynamic phantom using state-of-the-art CT systems in combination with specific reconstruction settings. Dose reduction resulted in increased noise and consequently increased CCS, whereas increased IR resulted in decreased CCS.
为评估在不同制造商的先进CT系统上,剂量降低联合迭代重建(IR)对动态体模中冠状动脉钙化积分(CCS)的影响。将钙化插件在仿真人体胸部体模中以20毫米/秒的速度移动,对应心率为60至75次/分钟。在四个高端CT系统上,使用常规CCS协议,分别以参考剂量、降低40%和80%的剂量对插件进行五次扫描。应用滤波反投影(FBP)和不同程度的IR。测定噪声水平。将以阿加斯顿积分和质量积分量化的CCS与FBP参考剂量下的物理质量和积分进行比较。对于参考剂量联合FBP,CT系统之间的噪声水平变化小于18%。降低剂量几乎总是导致CCS增加,而在IR程度增加时,CCS又会下降。IR对CCS的影响小于剂量降低的影响。在参考剂量下,物理质量被低估3%至30%。在40%剂量降低联合特定重建时,所有CT系统显示出相似的CCS。对于一些CT系统,在80%剂量降低联合IR时,CCS不受影响。这项多厂商研究表明,在使用先进CT系统联合特定重建设置的动态体模中,40%的辐射剂量降低不会影响CCS。剂量降低导致噪声增加,进而导致CCS增加,而IR增加则导致CCS降低。