Reduced Radiation Dose with Model Based Iterative Reconstruction Coronary Artery Calcium Scoring

Publication date: Available online 8 December 2018

Source: European Journal of Radiology

Author(s): Andrew D. Choi, Eric S. Leifer, Jeannie Yu, Tanuka Datta, Kathie Bronson, Shirley Rollison, John Schuzer, Chloe Steveson, Sujata M. Shanbhag, Marcus Y. Chen

Abstract

Assessing coronary artery calcium (CAC) is a valuable tool for individualizing cardiac risk assessment. In CAC scanning, this technical report assesses the use of a true model-based iterative reconstruction algorithm using forward projected model-based iterative reconstruction ("FIRST") and assess whether FIRST allows for reduced radiation dose CAC scanning on 320-detector row computed tomography (320-CT). Here, 100 consecutive patients prospectively underwent reduced and standard dose scans. For the patients (59 ± 9 years, 61% male) stratified by Agatston categories 0, 1-10, 11-100, 101-400,> 400, agreement between reduced dose with FIRST versus standard dose with FBP was excellent at 81% (95% CI: 73-88%) with kappa 0.74 (95% CI: 0.64–0.85). Median radiation exposure was 75% lower for reduced (0.35 mSv) versus standard dose (1.37 mSv) scans. In conclusion, agreement was excellent for reduced dose with FIRST and standard dose with FBP in 320-detector row CT CAC imaging in well-established categories of cardiovascular risk. These methods make it possible to reduce radiation exposure by 75%.

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