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  • Title: Radiation dose and image quality of 70 kVp cerebral CT angiography with optimized sinogram-affirmed iterative reconstruction: comparison with 120 kVp cerebral CT angiography.
    Author: Chen GZ, Zhang LJ, Schoepf UJ, Wichmann JL, Milliken CM, Zhou CS, Qi L, Luo S, Lu GM.
    Journal: Eur Radiol; 2015 May; 25(5):1453-63. PubMed ID: 25636415.
    Abstract:
    OBJECTIVES: To evaluate radiation dose, image quality, and optimal level of sinogram-affirmed iterative reconstruction (SAFIRE) of cerebral CT angiography (CTA) at 70 kVp. METHODS: One hundred patients were prospectively classified into two groups: Group A (n = 50), 70 kVp cerebral CTA with 5 levels of SAFIRE reconstruction (S1-S5); and Group B (n = 50), 120 kVp with filtered back projection (FBP) reconstruction. CT attenuation values, noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the internal carotid artery (ICA) and middle cerebral artery (MCA) were measured. Subjective image quality was evaluated. Effective dose (ED) was estimated. RESULTS: CT attenuation and noise of the ICA and MCA in Group A were higher than those of Group B (all P < 0.001) while the SNRICA, SNRMCA, CNRICA, and CNRMCA of Group A at S4-5 were comparable to (P > 0.05) or higher than in Group B (P < 0.05). There was no difference in overall image quality between Group A S3-5 and Group B (P > 0.05). ED was 0.2 ± 0.0 mSv for Group A with 85 % ED reduction in comparison to Group B (1.3 ± 0.2 mSv). CONCLUSION: Cerebral CTA at 70 kVp is feasible, allowing for substantial radiation dose reduction. SAFIRE S4 level is recommended for obtaining optimal image quality. KEY POINTS: • 70 kVp cerebral CTA is feasible and provides diagnostic image quality. • 70 kVp cerebral CTA resulted in 85% effective dose reduction. • S4 level of SAFIRE is recommended for 70 kVp cerebral CTA.
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