Automatic Tube Potential Selection with Tube Current Modulation (APSCM) in coronary CT angiography: Comparison of image quality and radiation dose with conventional body mass index-based protocol

Background: The use of Automatic Tube Potential Selection with Tube Current Modulation (APSCM) may lower radiation dose, but it is unknown whether image quality is maintained. Objective: The aim of this study was to evaluate the radiation dose and image quality of APSCM application compared with conventional body mass index (BMI)-based examination protocol for coronary computed tomography angiography (CTA). Methods: Consecutive patients (n = 487) were retrospectively enrolled: 239 patients who underwent coronary CTA with APSCM (APSCM group) and 248 patients who underwent coronary CTA with a BMI-based tube potential (in kV) and tube current-time product (in mAs) protocol (BMI-based group). Comparison of quantitative and qualitative image quality and radiation dose was performed. Results: The use of APSCM found significant reduction in radiation dose compared with the BMI-based protocol, with a significantly more frequent use of 80 kV (P < 0.0001). Diagnostic image quality was maintained, with no significant difference between the 2 groups (P = 0.887). Conclusion: The use of APSCM for coronary CTA significantly reduced radiation dose while maintaining image quality; therefore, it is feasible in daily practice which covers patients with various BMI values.