Newsletter - January 2014     Dear MDCT.net users, The series of MDCT.net newsletters dedicated to strategies for radiation dose reduction, which started last month, continues by taking on a new focus: balancing the risks and the benefits of cardiac CT. In recent years, new protocols for cardiac and coronary diagnostic imaging have been developed in order to obtain better quality images, improve the diagnostic yield and, concurrently, reduce patients' exposure to ionizing radiation. With this newsletter, MDCT.net is publishing new content on radiation dose reduction in cardiac CT. An overview of image reconstruction algorithms and their use in dose reduction is provided in a new Focus On by Rengo and Laghi . Dose reduction techniques specifically used in cardiac CT, namely ECG modulation of X-ray tube current during retrospective gating, prospective ECG triggering of axial acquisitions and single-heartbeat acquisition, are illustrated in the Focus On by Paul and Matarese . Additionally, an e-lecture given by Francone at the Cardiac Imaging 2013 conference , organized by the ESCR in London, describes low-radiation protocols for cardiac CT and coronary CT angiography as well as instruments for their optimization. Further analyses of these procedures and research in this context are provided by a new selection of recent literature and by links to related content from the MDCT.net archive. We are confident these new publications would enhance the awareness on the issues and opportunities in radiation dose reduction in cardiac CT. We welcome suggestions for new topics to be covered in future issues: please contact us at editorial@mdct.net . From the MDCT.net team     view » view »       Cardiovascular / Coronary arteries • Belgrano M, Bregant P, Djoguela MF et al. 256-slice CT coronary angiography: in vivo dosimetry and technique optimization. Radiol Med. 2013 Dec 12. [Epub ahead of print] Effective dose is usually calculated by multiplying the dose-length product, reported on the scanner console, by a conversion coefficient for the body region being studied. Researchers in Italy compared these calculated values to those measured in vivo using quantitative film. Their study, involving patients undergoing 256-slice coronary CT angiography for different clinical reasons and with different scanning protocols, confirms the scanner-reported values and illustrates how radiation exposure varies with the scanning protocol. view » • Yoo RE, Park EA, Lee W et al. Image quality of Adaptive Iterative Dose Reduction 3D of coronary CT angiography of 640-slice CT: comparison with filtered back-projection. Int J Cardiovasc Imaging. 2013 Mar;29(3):669-676 Researchers in Korea working with Toshiba tested the ADIR 3D algorithm in the elaboration of coronary CT angiograms from a 640-slice scanner. view » • van der Bijl N, Joemai RM, Mertens BJ et al. Effect of dose reduction on image quality and diagnostic performance in coronary computed tomography angiography. Int J Cardiovasc Imaging. 2013 Feb;29(2):453-61 In the interest of balancing the need for high image quality with the lowest possible effective dose on 64-slice coronary CT angiography, researchers in the Netherlands used software to simulate the increase in noise that would be produced by lowering the X-ray tube current. They found that a 50% reduction still generated diagnostic-quality images but further reductions compromised the diagnostic yield. view » • Gramer BM, Muenzel D, Leber V et al. Impact of iterative reconstruction on CNR and SNR in dynamic myocardial perfusion imaging in an animal model. Eur Radiol. 2012 Dec;22(12):2654-2661 Researchers in Germany working with Philips tested the functionality of the iDose4 algorithm in dynamic CT studies of perfusion in a pig model of myocardial ischemia. view » • Maffei E, Martini C, Rossi A et al. Diagnostic accuracy of second-generation dual-source computed tomography coronary angiography with iterative reconstructions: a real-world experience. Radiol Med. 2012 Aug;117(5):725-738 Researchers working mostly in Italy confirmed that, in clinical practice, the use of a dual-source (128x2) CT scanner with Siemen's IRIS algorithm provided high diagnostic accuracy for the detection of obstructive coronary artery disease. view » Further titles • Picano E, Vañó E, Rehani MM et al.  The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology. Eur Heart J. 2014 Jan 8. [Epub ahead of print] • Ghoshhajra BB, Lee AM, Engel LC et al. Radiation dose reduction in pediatric cardiac computed tomography: experience from a tertiary medical center. Pediatr Cardiol. 2014 Jan;35(1):171-179 • Lee AM, Beaudoin J, Engel LC et al. Assessment of image quality and radiation dose of prospectively ECG-triggered adaptive dual-source coronary computed tomography angiography (cCTA) with arrhythmia rejection algorithm in systole versus diastole: a retrospective cohort study. Int J Cardiovasc Imaging. 2013 Aug;29(6):1361-70 • Chen MY, Steigner ML, Leung SW et al. Simulated 50 % radiation dose reduction in coronary CT angiography using adaptive iterative dose reduction in three-dimensions (AIDR3D). Int J Cardiovasc Imaging. 2013 Jun;29(5):1167-1175       view »     From Basic Cardiac Imaging to Image Fusion Core Competencies Versus Technological Progress P. Marzullo, G. Mariani (Eds.) Springer 2013 • Table of Contents • How to Reduce the Radiation Burden in Cardiac CT view » Radiation Dose from Multidetector CT Tack Denis; Kalra, Mannudeep K.; Gevenois, Pierre Alain (Eds.) Springer 2012 • Table of Contents • Radiation Dose Optimisation of Cardiac and Vascular MDCT in Adults and Paediatric Patients view » Cardiac CT M. Dewey - Springer-Verlag Berlin Heidelberg 2011 • Table of Contents • Physics background and radiation exposure view »   FROM THE MDCT.net ARCHIVE     Cardiac malformation 1700 g premature neonate view »     Radiation dose in Cardiac Multislice CT JF Paul view » Cardiac CT and radiation dose: what is the risk in practice for the patient? JF Paul view » Reducing CT angiography radiation dose, not image quality L Williams view » Effects of X-ray tube parameters, iodine concentration, and patient size on image quality in a chest-phantom study JF Paul view »     Strategies for Radiation Dose Reduction in Cardiac CT F. Pugliese ESCR 2012, MDCT Symposium, Barcelona, October 26, 2012 view » Strategies for Radiation Dose Reduction in Vascular CT M. Francone ESCR 2012, MDCT Symposium, Barcelona, October 26, 2012 view » Cardiac CT: improved strategies for dose reduction F. Cademartiri ESCR 2011, Amsterdam October 2011 view » High Concentration Contrast Media and Radiation Dose Reduction in Cardiac CT F. Pugliese ECR 2011, MDCT Symposium, Vienna, Austria 3-7 March 2011 view »     Dose reduction strategies in contrast-enhanced CT Module 5: Low-dose cardiac CT angiography F. Cademartiri view »     MDCT.net's Guide to Technology and Protocols – Radiation Dose view »     If you wish to be removed from this email list, please click here If you would like to view our Privacy Policy, click here