Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients

Comparison with a body mass index-based protocol using the propensity score matching method

Hong Seon Lee, Young Joo Suh, Kyunghwa Han, Jin Young Kim, Suyon Chang, Dong Jin Im, Yoo Jin Hong, Hye Jeong Lee, Jin Hur, Youngjin Kim, Byoung Wook Choi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Reduced image quality from increased X-ray scatter and image noise can be problematic when coronary computed tomography angiography (CCTA) imaging is performed in obese patients. The aim of this study was to compare the image quality and radiation dose obtained using automatic tube potential selection with tube current modulation (APSCM) with those obtained using a body mass index (BMI)-based protocol for CCTA in obese patients. Methods A total of 203 consecutive obese (BMI > 30 kg/m2) patients were retrospectively enrolled, of whom 96 underwent CCTA with APSCM and 107 underwent a BMI-based protocol. After applying the propensity score matching method, the clinical parameters, subjective and objective image quality, and radiation dose were compared between the APSCM group and the matched BMI-based group. These parameters were also compared among different tube potential subgroups. Results No significant differences were observed between the APSCM group and the BMI-based group with respect to image quality or radiation dose assessment (p > 0.05). Twenty patients (21%) examined with 140 kV in the APSCM group were exposed to significantly more radiation (p < 0.05) than patients in the BMI-based group or patients in the other APSCM kV subgroups; significant improvement in image quality was not observed in the 140 kV subgroup. Patients with a high BMI and a large effective diameter tended to be examined with 140 kV (p < 0.05). Conclusion The use of APSCM for CCTA in obese patients did not significantly reduce the radiation dose or improve image quality compared with those in the matched BMI-based group. Our data indicate that it is better to avoid using APSCM when 140 kV is automatically selected, due to increased radiation dose and lack of significant improvement in image quality.

Original languageEnglish
Article numbere0190584
JournalPloS one
Volume13
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Propensity Score
Angiography
Coronary Angiography
body mass index
Image quality
Body Mass Index
Modulation
Dosimetry
Radiation
computed tomography
Tomography
dosage
methodology
Computed Tomography Angiography
X-radiation
Research Design
X-Rays
image analysis
Imaging techniques
X rays

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, Hong Seon ; Suh, Young Joo ; Han, Kyunghwa ; Kim, Jin Young ; Chang, Suyon ; Im, Dong Jin ; Hong, Yoo Jin ; Lee, Hye Jeong ; Hur, Jin ; Kim, Youngjin ; Choi, Byoung Wook. / Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients : Comparison with a body mass index-based protocol using the propensity score matching method. In: PloS one. 2018 ; Vol. 13, No. 1.
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title = "Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients: Comparison with a body mass index-based protocol using the propensity score matching method",
abstract = "Background Reduced image quality from increased X-ray scatter and image noise can be problematic when coronary computed tomography angiography (CCTA) imaging is performed in obese patients. The aim of this study was to compare the image quality and radiation dose obtained using automatic tube potential selection with tube current modulation (APSCM) with those obtained using a body mass index (BMI)-based protocol for CCTA in obese patients. Methods A total of 203 consecutive obese (BMI > 30 kg/m2) patients were retrospectively enrolled, of whom 96 underwent CCTA with APSCM and 107 underwent a BMI-based protocol. After applying the propensity score matching method, the clinical parameters, subjective and objective image quality, and radiation dose were compared between the APSCM group and the matched BMI-based group. These parameters were also compared among different tube potential subgroups. Results No significant differences were observed between the APSCM group and the BMI-based group with respect to image quality or radiation dose assessment (p > 0.05). Twenty patients (21{\%}) examined with 140 kV in the APSCM group were exposed to significantly more radiation (p < 0.05) than patients in the BMI-based group or patients in the other APSCM kV subgroups; significant improvement in image quality was not observed in the 140 kV subgroup. Patients with a high BMI and a large effective diameter tended to be examined with 140 kV (p < 0.05). Conclusion The use of APSCM for CCTA in obese patients did not significantly reduce the radiation dose or improve image quality compared with those in the matched BMI-based group. Our data indicate that it is better to avoid using APSCM when 140 kV is automatically selected, due to increased radiation dose and lack of significant improvement in image quality.",
author = "Lee, {Hong Seon} and Suh, {Young Joo} and Kyunghwa Han and Kim, {Jin Young} and Suyon Chang and Im, {Dong Jin} and Hong, {Yoo Jin} and Lee, {Hye Jeong} and Jin Hur and Youngjin Kim and Choi, {Byoung Wook}",
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Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients : Comparison with a body mass index-based protocol using the propensity score matching method. / Lee, Hong Seon; Suh, Young Joo; Han, Kyunghwa; Kim, Jin Young; Chang, Suyon; Im, Dong Jin; Hong, Yoo Jin; Lee, Hye Jeong; Hur, Jin; Kim, Youngjin; Choi, Byoung Wook.

In: PloS one, Vol. 13, No. 1, e0190584, 01.01.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effectiveness of automatic tube potential selection with tube current modulation in coronary CT angiography for obese patients

T2 - Comparison with a body mass index-based protocol using the propensity score matching method

AU - Lee, Hong Seon

AU - Suh, Young Joo

AU - Han, Kyunghwa

AU - Kim, Jin Young

AU - Chang, Suyon

AU - Im, Dong Jin

AU - Hong, Yoo Jin

AU - Lee, Hye Jeong

AU - Hur, Jin

AU - Kim, Youngjin

AU - Choi, Byoung Wook

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background Reduced image quality from increased X-ray scatter and image noise can be problematic when coronary computed tomography angiography (CCTA) imaging is performed in obese patients. The aim of this study was to compare the image quality and radiation dose obtained using automatic tube potential selection with tube current modulation (APSCM) with those obtained using a body mass index (BMI)-based protocol for CCTA in obese patients. Methods A total of 203 consecutive obese (BMI > 30 kg/m2) patients were retrospectively enrolled, of whom 96 underwent CCTA with APSCM and 107 underwent a BMI-based protocol. After applying the propensity score matching method, the clinical parameters, subjective and objective image quality, and radiation dose were compared between the APSCM group and the matched BMI-based group. These parameters were also compared among different tube potential subgroups. Results No significant differences were observed between the APSCM group and the BMI-based group with respect to image quality or radiation dose assessment (p > 0.05). Twenty patients (21%) examined with 140 kV in the APSCM group were exposed to significantly more radiation (p < 0.05) than patients in the BMI-based group or patients in the other APSCM kV subgroups; significant improvement in image quality was not observed in the 140 kV subgroup. Patients with a high BMI and a large effective diameter tended to be examined with 140 kV (p < 0.05). Conclusion The use of APSCM for CCTA in obese patients did not significantly reduce the radiation dose or improve image quality compared with those in the matched BMI-based group. Our data indicate that it is better to avoid using APSCM when 140 kV is automatically selected, due to increased radiation dose and lack of significant improvement in image quality.

AB - Background Reduced image quality from increased X-ray scatter and image noise can be problematic when coronary computed tomography angiography (CCTA) imaging is performed in obese patients. The aim of this study was to compare the image quality and radiation dose obtained using automatic tube potential selection with tube current modulation (APSCM) with those obtained using a body mass index (BMI)-based protocol for CCTA in obese patients. Methods A total of 203 consecutive obese (BMI > 30 kg/m2) patients were retrospectively enrolled, of whom 96 underwent CCTA with APSCM and 107 underwent a BMI-based protocol. After applying the propensity score matching method, the clinical parameters, subjective and objective image quality, and radiation dose were compared between the APSCM group and the matched BMI-based group. These parameters were also compared among different tube potential subgroups. Results No significant differences were observed between the APSCM group and the BMI-based group with respect to image quality or radiation dose assessment (p > 0.05). Twenty patients (21%) examined with 140 kV in the APSCM group were exposed to significantly more radiation (p < 0.05) than patients in the BMI-based group or patients in the other APSCM kV subgroups; significant improvement in image quality was not observed in the 140 kV subgroup. Patients with a high BMI and a large effective diameter tended to be examined with 140 kV (p < 0.05). Conclusion The use of APSCM for CCTA in obese patients did not significantly reduce the radiation dose or improve image quality compared with those in the matched BMI-based group. Our data indicate that it is better to avoid using APSCM when 140 kV is automatically selected, due to increased radiation dose and lack of significant improvement in image quality.

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