Evidence map›Paper›PMID 36987879›Full record

ArticleDiagnostic and interventional radiology (Ankara, Turkey)2023

Low-dose ultra-high-pitch computed tomography coronary angiography: identifying the optimum combination of iteration strength and radiation dose reduction strategies to achieve true submillisievert scans

Nidhi Kumari, Kartik P Ganga, Vineeta Ojha, Sanjeev Kumar, Priya Jagia, Nitish Naik, Gurpreet Gulati, Sanjiv Sharma

Abstract read
In one paragraph

Article in Diagnostic and interventional radiology (Ankara, Turkey), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nidhi KumariDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0001-9849-1888
Kartik P GangaDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0002-5391-8531
Vineeta OjhaDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0003-4371-5615
Sanjeev KumarDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0002-3467-8958
Priya JagiaDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0001-5605-8672
Nitish NaikDepartment of Cardiology, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0001-6002-5400
Gurpreet GulatiDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0003-1116-4767
Sanjiv SharmaDepartment of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaORCID 0000-0001-6718-3647

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo identify the optimum strength of advanced modeled iterative reconstruction (ADMIRE) to achieve the best subjective and objective image quality when combining three-dose reduction strategies, ultra-high-pitch computed tomography coronary angiography (FLASH CTCA; with single-dose ivabradine to lower heart rate), low tube voltage, and ADMIRE.

methodsSixty consecutive patients underwent FLASH CTCA at 100 kVp in this single-center prospective study. Single-dose ivabradine was administered to patients whose heart rate was above 75 bpm. Images were reconstructed using the three highest strengths of ADMIRE (A3, A4, and A5). Objective and subjective image quality (using a Likert scale) were evaluated in the three datasets.

resultsThe signal strength remained unchanged but mean noise significantly reduced across the increasing strengths of ADMIRE [signal: 513.78 ± 101.7 Hounsfield units (HU) at A3, 515.6 ± 100.5 HU at A4, and 519.7 ± 107.9 HU at A5; noise: 23.4 ± 4.5 HU at A3, 20.2 ± 3.6 HU at A4, and 17.2 ± 3.3 HU at A5]. Signal-to-noise and contrast-to-noise ratios were the highest at A5, and A5 offered significantly higher Likert scores in image noise, vessel sharpness, and overall image quality than A3 or A4. Additionally, A5 did not interfere with image interpretation in any patient.

conclusionUsing all three dose reduction strategies during FLASH CTCA along with single-dose ivabradine administration ensures minimal radiation exposure in daily practice. In this study, A5 datasets had the best overall subjective and objective image quality despite their "plastic appearance". In the future, enhanced dose reduction can be obtained by further lowering tube voltages.

Indexed as

Drug TaperingTomography, X-Ray ComputedAlgorithmsComputed Tomography AngiographyCoronary AngiographyHumansIvabradineProspective StudiesRadiation DosageRadiographic Image Interpretation, Computer-AssistedIvabradineAdvanced modeled iterative reconstructioncardiaccomputed tomography angiographydose reduction strategiesultra-high-pitch computed tomography coronary angiography

Identifiers

PMID36987879
PMCPMC10679714

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.