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BACKGROUND

Bigger is Not Always Better - A Prospective Randomized Canadian Trial Comparing 80 kV versus 100 kV Tube Voltage for Coronary Computed Tomographic Angiography

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BACKGROUND

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  1. Bigger is Not Always Better - A Prospective Randomized Canadian Trial Comparing 80 kV versus 100 kV Tube Voltage for Coronary Computed Tomographic Angiography Brett Heilbron 1, Carolyn Taylor 1, David Wood 1, G.B. John Mancini1, Fay Lin2, James Min 2, Troy LaBounty 2, Jonathon Leipsic1 1 St Paul’s Hospital, University of British Columbia, Vancouver, BC 2Weill Cornell Medical College at New York Presbyterian Hospital, New York, NY BACKGROUND RESULTS EXAMPLES Patient, Radiation Dose, and Image Characteristics by Group B) 80 kVp – total occlusion Coronary computed tomographic angiography (CCTA) using a tube voltage of 80 kV results in lower radiation exposure, however the magnitude of reduction and associated image quality in comparison to conventional higher tube voltage imaging is not well established. Reducing tube current increases image noise, but also increases contrast attenuation owing to a greater photoelectric effect. A) 80 kVp – noncalcified plaque METHODS We prospectively randomized 69 consecutive patients with a normal body mass index (BMI) of <25 kg/m2 and no prior coronary revascularization referred for clinically indicated CCTA to a single Canadian centre to 80 kV (n=37) versus 100 kV tube voltage (n=32). Tube current was 600-625 mA for all patients. Blinded CCTA core lab analysis was performed by 2 experienced readers for measures of signal and noise (mean of aortic root, left main artery, right coronary artery); contrast (mean signal - subcutaneous adipose tissue signal); and image quality (Likert scale 1-4). C) 100 kVp – mixed plaque A) 100 kVp – stent Mean+/- standard deviation or median (interquartile range) provided ACKNOWLEDGEMENTS CONCLUSIONS The Coronary Computed Tomography Angiography team of technicians, nurses, residents and clerks at St Paul’s Hospital The Department of Diagnostic Imaging, Providence Health Care and the Healthy Heart Society of BC for financial support of the Cardiac Computed Tomography Program at St Paul’s Hospital The use of a reduced tube voltage of 80 kV for clinically indicated CCTA in consecutive non-overweight patients allowed for a 66% reduction in radiation dose with a similar image quality. Further study is needed to assess the impact of 80kV imaging on quantitative measures of coronary stenosis.

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