Publication

Body Mass Index-Adapted Prospective Coronary Computed Tomography Angiography. Determining the Lowest Limit for Diagnostic Purposes

Cardiac

Eur J Radiol. 2013, Epub 2013 Jan 14.

Authors:

W. Hosch, NP. Hofmann, D. Mueller, J. Iwan, G. Gitsioudis, S. Siebert, E. Giannitsis, HU. Kauczor, HA. Katus, G. Korosoglou

Summary

The study evaluated radiation dose reduction strategies for coronary CT angiography (CCTA) using BMI-adapted protocols in 210 patients with suspected coronary artery disease.

Patients were divided into four groups:

  1. a non-tailored control protocol (120 kV, 200 mAs)
  2. three BMI-stratified protocols ("standard," "low dose," and "ultra-low dose") with progressively reduced tube voltage and current for BMI categories <25, 25–28, 28–30, and ≥30 kg/m².

Radiation exposure decreased significantly across protocols:

  • 3.2 ± 0.4 mSv (control)
  • 1.6 ± 0.7 mSv (standard)
  • 1.2 ± 0.6 mSv (low dose)
  • 0.7 ± 0.3 mSv (ultra-low dose),

    • achieving dose reductions of 50%, 63%, and 78%, respectively.

    Image quality remained diagnostic in standard and low-dose groups (scores 1.9–2.0) compared to the control (1.9 ± 0.5), but degraded in the ultra-low dose group (2.7 ± 0.6, p < 0.05).

    The authors concluded that BMI-adapted protocols with ~65% dose reduction (to ~1 mSv) maintain diagnostic accuracy, while ultra-low dose protocols compromise image quality and are unsuitable for clinical use.

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