TY - JOUR
AR - RDI-2019-4-101
TI - False-Positive Calcifications and Radiation Dose in Coronary Artery Calcium Scoring Using Iterative Reconstruction on The Basis of a Noise Threshold
AU - D., Grönemeyer
AU - B., Brandts
AU - C., Lehrenfeld
AU - F., Metz
AU - Marietta, Garmer
AU - O., Klein-Wiele
JO - Radiology and Medical Diagnostic Imaging
PY - 2019
DA - Wed 16, Oct 2019
SN - 2613-7836
DO - http://dx.doi.org/10.31487/j.RDI.2019.04.01
UR - https://www.sciencerepository.org/false-positive-calcifications-and-radiation-dose-in-coronary-artery-calcium-scoring-using-iterative-reconstruction-on-the-basis-of-a-noise-thr_RDI-2019-4-101 
KW - Coronary artery disease, vascular calcification, radiation exposure, image reconstruction, cardiac imaging techniques
AB - Radiation dose from cardiac CT seems to be underestimated. To determine the effect of iterative
reconstruction in coronary artery calcium (CAC) scoring on false positive lesions and radiation dose using
a noise threshold. Noise-based thresholds have been previously suggested to reduce false positive lesions in
lower dose protocols. In 388 matched pairs of patients we performed CAC scoring using a 320-row CTscanner with standard dose filtered backprojection (FBP) and lower dose iterative reconstruction (IR). Dose
modulation was based on a noise threshold. Radiation dose, image quality and extent of false-positive
calcifications were obtained. IR versus FBP showed a reduced dose length product (median 61 versus 74;
p< 0.001), less noise (median SD 14.71 versus 18.07; p< 0.001) and higher signal-to-noise ratio (median
4.01 versus 3.14; p< 0.001). Using IR in 388 patients, a low quantity of false-positive calcifications was
found in 302 patients, a moderate quantity in 76 patients and a high quantity in 10 patients, while using
FBP, the corresponding distribution of patients was 79, 175 and 134 (p<0.001). In this clinical setting we
confirm the observation of a phantom study that CAC scoring using iterative reconstruction and a noise
threshold is effective for the reduction of radiation dose.