CARDIAC IMAGING AND NON-INVASIVE TESTING

Use of automatic exposure control in multislice computed tomography of the coronaries: comparison of 16-slice and 64-slice scanner data with conventional coronary angiography

Anja Deetjen¹, Susanne Möllmann¹, Guido Conradi¹, Andreas Rolf¹, Axel Schmermund², Christian W Hamm¹, Thorsten Dill¹

¹ Department of Cardiology/Cardiovascular Imaging, Kerckhoff Heart Center, Bad Nauheim, Germany
² Cardioangiologisches Zentrum Bethanien, Im Prüfling, Frankfurt, Germany

Correspondence to:
Dr A Deetjen
Department of Cardiology, Katharinenhospital Stuttgart, Kriegsbergstr, 60 70174 Stuttgart, Germany; a.deetjen{at}katharinenhospital.de

Objective: To evaluate the radiation-dose-reduction potential of automatic exposure control (AEC) in 16-slice and 64-slice multislice computed tomography (MSCT) of the coronary arteries (computed tomography angiography, CTA) in patients. The rapid growth in MSCT CTA emphasises the necessity of adjusting technique factors to reduce radiation dose exposure.

Design: A retrospective data analysis was performed for 154 patients who had undergone MSCT CTA. Group 1 (n = 56) had undergone 16-slice MSCT without AEC, and group 2 (n = 51), with AEC. In group 1, invasive coronary angiography (ICA) had been performed in addition. Group 3 (n = 47) had been examined using a 64-slice scanner (with AEC, without ECG-triggered tube current modulation).

Results: In group 1, the mean (SD) effective dose (ED) for MSCT CTA was 9.76 (1.84) mSv and for ICA it was 2.6 (1.27) mSv. In group 2, the mean ED for MSCT CTA was 5.83 (1.73) mSv, which signifies a 42.8% dose reduction for CTA by the use of AEC. In comparison to ICA, MSCT CTA without AEC shows a 3.8-fold increase in radiation dose, and the radiation dose of CTA with AEC was increased by a factor of 1.9. In group 3, the mean ED for MSCT CTA was 13.58 (2.80) mSV.

Conclusions: This is the first study to show the significant dose-reduction potential (42.8%) of AEC in MSCT CTA in patients. This relatively new technique can be used to optimise the radiation dose levels in MSCT CTA.

Abbreviations: AEC, automatic exposure control; BSA, body surface area; CaSc, calciumscore scan; CTA, computed tomography angiography; DLP, dose–length product; ECG-TTCM, ECG-triggered tube current modulation; ED, effective dose; HR, heart rate; ICA, invasive coronary angiography; MSCT, multislice computed tomography

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