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. 2018 Jul;16(1):253-259.
doi: 10.3892/etm.2018.6158. Epub 2018 May 11.

Automatic tube potential selection with tube current modulation in coronary CT angiography: Can it achieve consistent image quality among various individuals?

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Automatic tube potential selection with tube current modulation in coronary CT angiography: Can it achieve consistent image quality among various individuals?

Xiao-Ping Wang et al. Exp Ther Med. 2018 Jul.

Abstract

The present study included a total of 111 consecutive patients who had undergone coronary computed tomography (CT) angiography, using a first-generation dual-source CT with automatic tube potential selection and tube current modulation. Body weight (BW) and body mass index (BMI) were recorded prior to CT examinations. Image noise and attenuation of the proximal ascending aorta (AA) and descending aorta (DA) at the middle level of the left ventricle were measured. Correlations between BW, BMI and objective image quality were evaluated using linear regression. In addition, two subgroups based on BMI (BMI ≤25 and >25 kg/m2) were analyzed. Subjective image quality, image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) were all compared between those. The image noise of the AA increased with the BW and BMI (BW: r=0.453, P<0.001; BMI: r=0.545, P<0.001). The CNR and SNR of the AA were inversely correlated with BW and BMI, respectively. The image noise of the DA and the CNR and SNR of the DA exhibited a similar association to those with the BW or BMI. The BMI >25 kg/m2 group had a significant increase in image noise (33.1±6.9 vs. 27.8±4.0 HU, P<0.05) and a significant reduction in CNR and SNR, when compared with those in the BMI ≤25 kg/m2 group (CNR: 18.9±4.3 vs. 16.1±3.7, P<0.05; SNR: 16.0±3.8 vs. 13.6±3.2, P<0.05). Patients with a BMI of ≤25 kg/m2 had more coronary artery segments scored as excellent, compared with patients with a BMI of >25 kg/m2 (P=0.02). In conclusion, this method is not able to achieve a consistent objective image quality across the entire patient population. The impact of BW and BMI on objective image quality was not completely eliminated. BMI-based adjustment of the tube potential may achieve a more consistent image quality compared to automatic tube potential selection, particularly in patients with a larger body habitus.

Keywords: body mass index; contrast-to-noise ratio; coronary computed tomography angiography; image consistency; image noise.

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Figures

Figure 1.
Figure 1.
Correlation between BW, BMI and image noise of DA. The scattergrams depict a positive correlation between BW, BMI and image noise of DA. DA, descending aorta; BW, body weight; BMI, body mass index.
Figure 2.
Figure 2.
Correlation between BMI and CNR, SNR of the DA. The scattergrams depict a negative correlation between the BMI and the CNR or SNR of the DA. CNR, contrast-to-noise ratio; SNR, signal-to-noise ratio; DA, descending aorta; BMI, body mass index.
Figure 3.
Figure 3.
Comparison of noise and CNR of the descending aorta between patients with a BMI of ≤25 kg/m2 and those with a BMI of >25 kg/m2. Horizontal lines represent the mean; boxes, meanquartile deviation; white dots, discrete values; and stars indicate extreme values. BMI, body mass index (calculated as weight in kg/height in m2); CNR, contrast-to-noise ratio.

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