Tube Voltage, DNA Double-Strand Breaks, and Image Quality in Coronary CT Angiography

• Published in: Korean journal of radiology Vol. 21; no. 8; pp. 967 - 977
• Main Authors: Lin, Zhu Xiao, Zhou, Fan, Schoepf, U. Joseph, Pillai, Balakrishnan, Zhou, Chang Sheng, Quan, Wei, Bao, Xue Qin, Lu, Guang Ming, Zhang, Long Jiang
• Format: Journal Article
• Language: English
• Published: Seoul The Korean Society of Radiology 01.08.2020; 대한영상의학회
• Subjects: Antibodies; Automation; Body mass index; Cardiovascular disease; Cardiovascular Imaging; Clinical medicine; Coronary vessels; DNA damage; Electrocardiography; Flow cytometry; Lymphocytes; Medical imaging; Microscopy; Patients; Radiation; Vein & artery diseases; X-rays; 방사선과학; United Kingdom > UK; United States > US; Germany
• ISSN: 1229-6929; 2005-8330
• DOI: 10.3348/kjr.2019.0932

Objective To evaluate the effects of tube voltage on image quality in coronary CT angiography (CCTA), the estimated radiation dose, and DNA double-strand breaks (DSBs) in peripheral blood lymphocytes to optimize the use of CCTA in the era of low radiation doses. Materials and Methods This study included 240 patients who were divided into 2 groups according to the DNA DSB analysis methods, i.e., immunofluorescence microscopy and flow cytometry. Each group was subdivided into 4 subgroups: those receiving CCTA only with different tube voltages of 120, 100, 80, or 70 kVp. Objective and subjective image quality was evaluated by analysis of variance. Radiation dosages were also recorded and compared. Results There was no significant difference in demographic characteristics between the 2 groups and 4 subgroups in each group (all p > 0.05). As tube voltage decreased, both image quality and radiation dose decreased gradually and significantly. After CCTA, γ-H2AX foci and mean fluorescence intensity in the 120-, 100-, 80-, and 70-kVp groups increased by 0.14, 0.09, 0.07, and 0.06 foci per cell and 21.26, 9.13, 8.10, and 7.13 (all ppp > 0.05). Conclusion The 100-kVp tube voltage may be optimal for CCTA when weighing DNA DSBs against the estimated radiation dose and image quality, with further reductions in tube voltage being unnecessary for CCTA.