PURPOSE To investigate the effect of an iterative beam-hardening correction algorithm (iBHC) on artifact reduction and image quality in coronary CT angiography (cCTA) with low tube voltage. MATERIAL AND METHODS… Click to show full abstract
PURPOSE To investigate the effect of an iterative beam-hardening correction algorithm (iBHC) on artifact reduction and image quality in coronary CT angiography (cCTA) with low tube voltage. MATERIAL AND METHODS Thirty-six patients (17 male, mean age, 57.3 ± 14.5 years) were prospectively enrolled in this IRB-approved study and underwent 70-kV cCTA using a third-generation dual-source CT scanner. Images were reconstructed using a standard algorithm (Bv36) both with and without the iBHC technique. Several region-of-interest (ROI) measurements were performed in the inferior wall of the left ventricle (LV), an area prone to beam-hardening, as well as other myocardial regions. Coronary contrast-to-noise (CNR) and signal-to-noise ratios (SNR) were calculated. Two radiologists assessed subjective image quality. RESULTS The iBHC algorithm generally increased myocardial attenuation in all ROIs (P < 0.566); however, the increase was significantly more distinct in beam-hardening prone areas such as the inferior LV (increase, +13.9 HU, +18.6%, P < 0.001), compared to the remaining myocardium (increase, +4.4 HU, +4.5%, P < 0.003). While no significant difference was found for image noise (P < 0.092), greater CNR and SNR values for the left main coronary artery (increase, +20.7% and +17.3%, respectively) were found using the iBHC algorithm (both with P < 0.001). Subjective image quality was comparable between both image series (P = 0.217). CONCLUSION The iBHC post-processing algorithm leads to significantly reduced beam-hardening while providing improved objective and equivalent subjective image quality in 70-kV cCTA.
               
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