Third-Generation Dual-Source Computed Tomography for Coronary Angiography With Individually Tailored Scan Protocols Can Achieve a Low Radiation Dose With Good Image Quality in Unselected Patients

OBJECTIVE: To explore the image quality and radiation exposure associated with coronary angiography obtained with a third-generation dual-source computed tomography, using body mass index (BMI)- and heart rate (HR)-adapted protocols in real-world patients. METHODS: Three scan protocols were implemented with regard to HR: prospective turbo high-pitch spiral, sequential, and retrospective spiral modes. We adapted the reference kilovoltage value according to BMI. Image quality was evaluated using a 4-point scale, and effective dose estimates were calculated using the dose-length product. RESULTS: Among the 896 patients, 417 (46.54%), 433 (48.32%), and 45 (5.02%) were imaged using prospective turbo high-pitch spiral, sequential, and retrospective spiral modes, respectively. The median BMI was 27.3 (25-30.4) kg/m2, and the effective dose was 0.65 mSv (interquartile range, 0.33-1.56 mSv). Only 32 of 896 examinations (3.5%) had poor image quality. CONCLUSIONS: Computed tomography angiography with BMI- and HR-tailored protocols offers good image quality with low radiation dose in unselected patients.