• Yang Hou, Jiahe Zheng, Yuke Wang, Mei Yu, Mani Vembar, and Qiyong Guo.
• Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
• Plos One. 2013 Jan 1; 8 (2): e56295.

AimTo investigate the potential of reducing the radiation dose in prospectively electrocardiogram-triggered coronary computed tomography angiography (CCTA) while maintaining diagnostic image quality using an iterative reconstruction technique (IRT).Methods And MaterialsProspectively-gated CCTA were first performed on a phantom using 256-slice multi-detector CT scanner at 120 kVp, with the tube output gradually reduced from 210 mAs (Group A) to 125, 105, 84, and 63 mAs (Group B-E). All scans were reconstructed using filtered back projection (FBP) algorithm and five IRT levels (L2-6), image quality (IQ) assessment was performed. Based on the IQ assessment, Group D(120 kVp, 84 mAs) reconstructed with L5 was found to provide IQ comparable to that of Group A with FBP. In the patient study, 21 patients underwent CCTA using 120 kV, 210 mAs with FBP reconstruction (Group 1) followed by 36 patients scanned with 120 kV, 84 mAs with IRT L5 (Group 2). Subjective and objective IQ and effective radiation dose were compared between two groups.ResultsIn the phantom scans, there were no significant differences in image noise, contrast-to-noise ratio (CNR) and modulation transfer function (MTF) curves between Group A and the 84 mAs, 63 mAs groups (Groups D and E). Group D (120 kV, 84 mAs and L5) provided an optimum balance, producing equivalent image quality to Group A, at the lowest possible radiation dose. In the patient study, there were no significant difference in image noise, signal-to-noise ratio (SNR) and CNR between Group 1 and Group 2 (p=0.71, 0.31, 0.5, respectively). The effective radiation dose in Group 2 was 1.21 ± 0.14 mSv compared to 3.20 ± 0.58 mSv (Group 1), reflecting dose savings of 62.5% (p<0.05).Conclusioniterative reconstruction technique used in prospectively ECG-triggered 256-slice coronary CTA can provide radiation dose reductions of up to 62.5% with acceptable image quality.

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