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The impact of dose reduction on the quantification of coronary artery calcifications and risk categorization: A systematic review

Vonder, M., van der Werf, N. R., Leiner, T., Greuter, M. J. W., Fleischmann, D., Vliegenthart, R., Oudkerk, M. & Willemink, M. J., 2018, In : Journal of Cardiovascular Computed Tomography. 12, 5, p. 352-363 12 p.

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  • The impact of dose reduction on the quantification of coronary artery calcifications and risk categorization A systematic review

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DOI

Multiple dose reduction techniques have been introduced for coronary artery calcium (CAC) computed tomography (CT), but few have emerged into clinical practice while an increasing number of patients undergo CAC scanning. We sought to determine to what extend the radiation dose in CAC CT can be safely reduced without a significant impact on cardiovascular disease (CVD) risk stratification. A systematic database-review of articles published from 2002 until February 2018 was performed in Pubmed, WebOfScience, and Embase. Eligible studies reported radiation dose reduction for CAC CT, calcium scores and/or risk stratification for phantom or patient studies. Twenty-eight studies were included, under which 17 patient studies, 10 phantom/ex-vivo studies, and 1 study evaluated both phantom and patients. Dose was reduced with tube voltage reduction and tube current reduction with and without iterative reconstruction (IR), and tin-filter spectral shaping. The different dose reduction techniques resulted in varying final radiation doses and had varying impact on CAC scores and CVD risk stratification. In 78% of the studies the radiation dose was reduced by >= 50% ranging from (CTDIvol) 0.6-5.5 mGy, leading to reclassification rates ranging between 3% and 21%, depending on the acquisition technique. Specific dose reduced protocols, including either tube current reduction and IR or spectral shaping with tin filtration, that showed low reclassification rates may potentially be used in CAC scanning and in future population-based screening for CVD risk stratification.

Original languageEnglish
Pages (from-to)352-363
Number of pages12
JournalJournal of Cardiovascular Computed Tomography
Volume12
Issue number5
Early online date15-Jun-2018
Publication statusPublished - 2018

    Keywords

  • Computed tomography, Coronary vessels, Cardiovascular diseases, Radiation exposure, Radiation dosage, Phantoms, Imaging, LOW-TUBE-VOLTAGE, DUAL-SOURCE CT, CARDIOVASCULAR COMPUTED-TOMOGRAPHY, ITERATIVE IMAGE-RECONSTRUCTION, PITCH SPIRAL ACQUISITION, CALCIUM SCORES, RADIATION-EXPOSURE, DIFFERENT VENDORS, ROW CT, ANGIOGRAPHY

ID: 62556908