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Eur Radiol. 2014 Jul;24(7):1643-50. doi: 10.1007/s00330-014-3194-x. Epub 2014 May 10.

Image quality and radiation dose of low tube voltage 3rd generation dual-source coronary CT angiography in obese patients: a phantom study.

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Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC, 29425-2260, USA.



To assess the influence of tube potential on radiation dose and image quality of third-generation dual-source coronary CT angiography (CTA) in a phantom simulating an obese patient.


A thoracic phantom was equipped with tubular inserts containing iodine solution and water. A soft-tissue-equivalent ring around the phantom simulated an obese patient. Images were acquired at tube potentials of 80, 100, 120 and 140 kV with second-generation dual-source CT (DSCT) and 70-150 kV (in 10-kV increments) with third-generation DSCT. Contrast-to-noise ratio (CNR) was calculated and CT dose index was recorded.


With second-generation DSCT, CNR was highest for 120 kV (19.0) and decreased with lower tube potential (12.0 at 80 kV) owing to disproportionately increased image noise. With third-generation DSCT, 70- and 80-kV acquisitions showed a smaller increase in noise. CNRs for third-generation DSCT were highest for 70 and 80 kV (21.1 and 21.2, respectively). Compared to 120 kV, radiation dose was 68% and 49% lower at 70 kV and 80 kV, respectively.


Third-generation DSCT enables one to perform coronary CTA at 70-80 kV in obese patients without compromising CNR and thus reduces radiation dose by 49-68%.


• Low tube potential CT angiography is currently not suitable for obese patients. • Third-generation DSCT offers substantially increased tube power at low tube potential. • This enables one to perform coronary CT angiography at 70-80 kV in obese patients. • Signal-to-noise ratio is maintained owing to increased tube current. • This approach can be expected to reduce radiation dose by 49-68%.

[Indexed for MEDLINE]

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