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Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta.

Publication ,  Journal Article
Schabel, C; Marin, D; Ketelsen, D; Farjat, AE; Bier, G; Lescan, M; Bamberg, F; Nikolaou, K; Bongers, MN
Published in: Eur Radiol
May 2018

OBJECTIVES: To compare a low-dose, tin-filtered, nonenhanced, high-pitch Sn100 kVp CT protocol (Sn100) with a standard protocol (STP) for the detection of calcifications in the ascending aorta in patients scheduled for cardiac surgery. METHODS: Institutional Review Board approval for this retrospective study was waived and the study was HIPAA-compliant. The study included 192 patients (128 men; age 68.8 ± 9.9 years), of whom 87 received the STP and 105 the Sn100 protocol. Size-specific dose estimates (SSDE) and radiation doses were obtained using dose monitoring software. Two blinded readers evaluated image quality on a scale from 1 (low) to 5 (high) and the extent of calcifications of the ascending aorta on a scale from 0 (none) to 10 (high), subdivided into 12 anatomic segments. RESULTS: The Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy and 0.20 ± 0.04 mSv compared with the mean SSDE of 5.4 ± 2.2 mGy achieved with the STP protocol (p < 0.0001). Calcification burden was associated with age (p < 0.0001), but was independent of protocol with mean calcification scores of 0.48 ± 1.23 (STP) and 0.55 ± 1.25 (Sn100, p = 0.18). Reader agreement was very good (STP κ = 0.87 ± 0.02, Sn100 κ = 0.88 ± 0.01). The STP protocol provided a higher subjective image quality than the Sn100 protocol: STP median 4, interquartile range 4-5, vs. SN100 3, 3-4; p < 0.0001) and a slightly better depiction of calcification (STP 5, 4-5, vs. Sn100 4, 4-5; p < 0.0001). CONCLUSIONS: The optimized Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy while the depiction of calcifications remained good, and there was no systematic difference in calcification burden between the two protocols. KEY POINTS: • Tin-filtered, low-dose CT can be used to assess aortic calcifications before cardiac surgery • An optimized Sn100 protocol achieved a mean SSDE of only 0.5 ± 0.1 mGy • The depiction of atherosclerosis of the thoracic aorta was similar with both protocols • The depiction of relevant thoracic pathologies before cardiac surgery was similar with both protocols.

Duke Scholars

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

May 2018

Volume

28

Issue

5

Start / End Page

1818 / 1825

Location

Germany

Related Subject Headings

  • Vascular Calcification
  • Tin
  • Retrospective Studies
  • Radiography, Thoracic
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Humans
  • Female
 

Citation

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Schabel, C., Marin, D., Ketelsen, D., Farjat, A. E., Bier, G., Lescan, M., … Bongers, M. N. (2018). Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta. Eur Radiol, 28(5), 1818–1825. https://doi.org/10.1007/s00330-017-5168-2
Schabel, Christoph, Daniele Marin, Dominik Ketelsen, Alfredo E. Farjat, Georg Bier, Mario Lescan, Fabian Bamberg, Konstantin Nikolaou, and Malte N. Bongers. “Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta.Eur Radiol 28, no. 5 (May 2018): 1818–25. https://doi.org/10.1007/s00330-017-5168-2.
Schabel C, Marin D, Ketelsen D, Farjat AE, Bier G, Lescan M, et al. Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta. Eur Radiol. 2018 May;28(5):1818–25.
Schabel, Christoph, et al. “Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta.Eur Radiol, vol. 28, no. 5, May 2018, pp. 1818–25. Pubmed, doi:10.1007/s00330-017-5168-2.
Schabel C, Marin D, Ketelsen D, Farjat AE, Bier G, Lescan M, Bamberg F, Nikolaou K, Bongers MN. Tin-filtered low-dose chest CT to quantify macroscopic calcification burden of the thoracic aorta. Eur Radiol. 2018 May;28(5):1818–1825.
Journal cover image

Published In

Eur Radiol

DOI

EISSN

1432-1084

Publication Date

May 2018

Volume

28

Issue

5

Start / End Page

1818 / 1825

Location

Germany

Related Subject Headings

  • Vascular Calcification
  • Tin
  • Retrospective Studies
  • Radiography, Thoracic
  • Radiation Dosage
  • Nuclear Medicine & Medical Imaging
  • Multidetector Computed Tomography
  • Male
  • Humans
  • Female