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Adenosine-stress dynamic myocardial perfusion imaging using 128-slice dual-source CT: optimization of the CT protocol to reduce the radiation dose

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Abstract

The aim of this study was to compare the radiation dose and image quality of different adenosine-stress dynamic myocardial perfusion CT protocols using a 128-slice dual-source computed tomography (DSCT) scanner. We included 330 consecutive patients with suspected coronary artery disease. Protocols employed the following dynamic scan parameters: protocol I, a 30-s scan with a fixed tube current (FTC, n = 172); protocol II, a 30-s scan using an automatic tube current modulation (ATCM) technique (n = 108); protocol III, a 14-s scan using an ATCM (n = 50). To determine the scan interval for protocol III, we analyzed time-attenuation curves of 26 patients with myocardial perfusion who had been scanned using protocol I or II. The maximum attenuation difference between normal and abnormal myocardium occurred at 18.0 s to 30.3 s after initiation of contrast injection. Myocardial perfusion images of FTC and ATCM were of diagnostic image quality based on visual analysis. The mean radiation dose associated with protocols I, II, and III was 12.1 ± 1.6 mSv, 7.7 ± 2.5 mSv, and 3.8 ± 1.3 mSv, respectively (p < 0.01). Use of a dose-modulation technique and a 14-s scan duration for adenosine-stress CT enables significant dose reduction while maintaining diagnostic image quality.

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Abbreviations

DSCT:

Dual-source computed tomography

FTC:

Fixed tube current

ATCM:

Automatic tube current modulation

CAD:

Coronary artery disease

MDCT:

Multidetector computed tomography

CCTA:

Coronary CT angiography

MBF:

Myocardial blood flow

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Authors and Affiliations

  1. Department of Radiology and Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Sung Mok Kim, Yoo Na Kim & Yeon Hyeon Choe

  2. Department of Radiology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea

    Yoo Na Kim

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  1. Sung Mok Kim
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  2. Yoo Na Kim
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Correspondence to Yeon Hyeon Choe.

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Kim, S.M., Kim, Y.N. & Choe, Y.H. Adenosine-stress dynamic myocardial perfusion imaging using 128-slice dual-source CT: optimization of the CT protocol to reduce the radiation dose. Int J Cardiovasc Imaging 29, 875–884 (2013). https://doi.org/10.1007/s10554-012-0138-x

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  • DOI: https://doi.org/10.1007/s10554-012-0138-x

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