Effect of automated tube voltage selection, integrated circuit detector and advanced iterative reconstruction on radiation dose and image quality of 3rd generation dual-source aortic CT angiography: An intra-individual comparison

• Aortic CTA protocols using 2nd and 3rd generation DSCT were compared.
• ATVS decreased the tube voltage resulting in overall radiation dose reduction.
• Low-kV acquisition allowed for a substantial reduction of contrast medium.
• A radiation and contrast dose reduction of 47.7% and 37.5% was achieved.

PurposeTo compare, on an intra-individual basis, the effect of automated tube voltage selection (ATVS), integrated circuit detector and advanced iterative reconstruction on radiation dose and image quality of aortic CTA studies using 2nd and 3rd generation dual-source CT (DSCT).Material and methodsWe retrospectively evaluated 32 patients who had undergone CTA of the entire aorta with both 2nd generation DSCT at 120 kV using filtered back projection (FBP) (protocol 1) and 3rd generation DSCT using ATVS, an integrated circuit detector and advanced iterative reconstruction (protocol 2). Contrast-to-noise ratio (CNR) was calculated. Image quality was subjectively evaluated using a five-point scale. Radiation dose parameters were recorded.ResultsAll studies were considered of diagnostic image quality. CNR was significantly higher with protocol 2 (15.0 ± 5.2 vs 11.0 ± 4.2; p < .0001). Subjective image quality analysis revealed no significant differences for evaluation of attenuation (p = 0.08501) but image noise was rated significantly lower with protocol 2 (p = 0.0005). Mean tube voltage and effective dose were 94.7 ± 14.1 kV and 6.7 ± 3.9 mSv with protocol 2; 120 ± 0 kV and 11.5 ± 5.2 mSv with protocol 1 (p < 0.0001, respectively).ConclusionAortic CTA performed with 3rd generation DSCT, ATVS, integrated circuit detector, and advanced iterative reconstruction allow a substantial reduction of radiation exposure while improving image quality in comparison to 120 kV imaging with FBP.