Hu Xi, Tao Xinwei, Zhang Yueqiao, Niu Zhongfeng, Zhang Yong, Allmendinger Thomas, Kuang Yu, Chen Bin
Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Siemens Healthineers China, Shanghai, China.
Korean J Radiol. 2021 Nov;22(11):1777-1785. doi: 10.3348/kjr.2021.0050. Epub 2021 Aug 19.
To investigate the accuracy of the Agatston score obtained with the ultra-high-pitch (UHP) acquisition mode using tin-filter spectral shaping (Sn150 kVp) and a kVp-independent reconstruction algorithm to reduce the radiation dose.
This prospective study included 114 patients (mean ± standard deviation, 60.3 ± 9.8 years; 74 male) who underwent a standard 120 kVp scan and an additional UHP Sn150 kVp scan for coronary artery calcification scoring (CACS). These two datasets were reconstructed using a standard reconstruction algorithm (120 kVp + Qr36d, protocol A; Sn150 kVp + Qr36d, protocol B). In addition, the Sn150 kVp dataset was reconstructed using a kVp-independent reconstruction algorithm (Sn150 kVp + Sa36d, protocol C). The Agatston scores for protocols A and B, as well as protocols A and C, were compared. The agreement between the scores was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. The radiation doses for the 120 kVp and UHP Sn150 kVp acquisition modes were also compared.
No significant difference was observed in the Agatston score for protocols A (median, 63.05; interquartile range [IQR], 0-232.28) and C (median, 60.25; IQR, 0-195.20) ( = 0.060). The mean difference in the Agatston score for protocols A and C was relatively small (-7.82) and with the limits of agreement from -65.20 to 49.56 (ICC = 0.997). The Agatston score for protocol B (median, 34.85; IQR, 0-120.73) was significantly underestimated compared with that for protocol A ( < 0.001). The UHP Sn150 kVp mode facilitated an effective radiation dose reduction by approximately 30% (0.58 vs. 0.82 mSv, < 0.001) from that associated with the standard 120 kVp mode.
The Agatston scores for CACS with the UHP Sn150 kVp mode with a kVp-independent reconstruction algorithm and the standard 120 kVp demonstrated excellent agreement with a small mean difference and narrow agreement limits. The UHP Sn150 kVp mode allowed a significant reduction in the radiation dose.
研究采用锡滤过光谱整形（Sn150 kVp）和kVp独立重建算法的超高螺距（UHP）采集模式获取的阿加斯顿积分的准确性，以降低辐射剂量。
这项前瞻性研究纳入了114例患者（平均±标准差，60.3±9.8岁；74例男性），这些患者接受了标准的120 kVp扫描以及额外的用于冠状动脉钙化评分（CACS）的UHP Sn150 kVp扫描。这两个数据集使用标准重建算法进行重建（120 kVp + Qr36d，方案A；Sn150 kVp + Qr36d，方案B）。此外，Sn150 kVp数据集使用kVp独立重建算法进行重建（Sn150 kVp + Sa36d，方案C）。比较了方案A和B以及方案A和C的阿加斯顿积分。使用组内相关系数（ICC）和布兰德 - 奥特曼图评估积分之间的一致性。还比较了120 kVp和UHP Sn150 kVp采集模式的辐射剂量。
方案A（中位数，63.05；四分位间距[IQR]，0 - 232.28）和方案C（中位数，60.25；IQR，0 - 195.20）的阿加斯顿积分未观察到显著差异（P = 0.060）。方案A和C的阿加斯顿积分的平均差异相对较小（-7.82），一致性界限为-65.20至49.56（ICC = 0.997）。与方案A相比，方案B的阿加斯顿积分（中位数，34.85；IQR，0 - 120.73）被显著低估（P < 0.001）。UHP Sn150 kVp模式使辐射剂量比标准120 kVp模式有效降低了约30%（0.58对0.82 mSv，P < 0.001）。
采用kVp独立重建算法的UHP Sn150 kVp模式用于CACS的阿加斯顿积分与标准120 kVp模式具有良好的一致性，平均差异小且一致性界限窄。UHP Sn150 kVp模式可显著降低辐射剂量。
