Dose reduction assessment in dynamic CT myocardial perfusion imaging in a porcine balloon-induced-ischemia model

Rachid Fahmi; Brendan L. Eck; Mani Vembar; Hiram G. Bezerra; David L. Wilson

doi:10.1117/12.2043748

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19 March 2014 Dose reduction assessment in dynamic CT myocardial perfusion imaging in a porcine balloon-induced-ischemia model

Rachid Fahmi, Brendan L. Eck, Mani Vembar, Hiram G. Bezerra, David L. Wilson

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Proceedings Volume 9033, Medical Imaging 2014: Physics of Medical Imaging; 903305 (2014) https://doi.org/10.1117/12.2043748
Event: SPIE Medical Imaging, 2014, San Diego, California, United States

Abstract

We investigated the use of an advanced hybrid iterative reconstruction (IR) technique (iDose4, Philips Health- care) for low dose dynamic myocardial CT perfusion (CTP) imaging. A porcine model was created to mimic coronary stenosis through partial occlusion of the left anterior descending (LAD) artery with a balloon catheter. The severity of LAD occlusion was adjusted with FFR measurements. Dynamic CT images were acquired at end-systole (45% R-R) using a multi-detector CT (MDCT) scanner. Various corrections were applied to the acquired scans to reduce motion and imaging artifacts. Absolute myocardial blood flow (MBF) was computed with a deconvolution-based approach using singular value decomposition (SVD). We compared a high and a low dose radiation protocol corresponding to two different tube-voltage/tube-current combinations (80kV p/100mAs and 120kV p/150mAs). The corresponding radiation doses for these protocols are 7.8mSv and 34.3mSV , respectively. The images were reconstructed using conventional FBP and three noise-reduction strengths of the IR method, iDose. Flow contrast-to-noise ratio, CNR_f, as obtained from MBF maps, was used to quantitatively evaluate the effect of reconstruction on contrast between normal and ischemic myocardial tissue. Preliminary results showed that the use of iDose to reconstruct low dose images provide better or comparable CNR_f to that of high dose images reconstructed with FBP, suggesting significant dose savings. CNR_f was improved with the three used levels of iDose compared to FBP for both protocols. When using the entire 4D dynamic sequence for MBF computation, a 77% dose reduction was achieved, while considering only half the scans (i.e., every other heart cycle) allowed even further dose reduction while maintaining relatively higher CNR_f.

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Rachid Fahmi, Brendan L. Eck, Mani Vembar, Hiram G. Bezerra, and David L. Wilson "Dose reduction assessment in dynamic CT myocardial perfusion imaging in a porcine balloon-induced-ischemia model", Proc. SPIE 9033, Medical Imaging 2014: Physics of Medical Imaging, 903305 (19 March 2014); https://doi.org/10.1117/12.2043748

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