Automatic Tube Potential Selection with Tube Current Modulation (APSCM) in coronary CT angiography: Comparison of image quality and radiation dose with conventional body mass index-based protocol

Background The use of Automatic Tube Potential Selection with Tube Current Modulation (APSCM) may lower radiation dose, but it is unknown whether image quality is maintained. Objective The aim of this study was to evaluate the radiation dose and image quality of APSCM application compared with conventional body mass index (BMI)–based examination protocol for coronary computed tomography angiography (CTA). Methods Consecutive patients (n = 487) were retrospectively enrolled: 239 patients who underwent coronary CTA with APSCM (APSCM group) and 248 patients who underwent coronary CTA with a BMI-based tube potential (in kV) and tube current-time product (in mAs) protocol (BMI-based group). Comparison of quantitative and qualitative image quality and radiation dose was performed. Results The use of APSCM found significant reduction in radiation dose compared with the BMI-based protocol, with a significantly more frequent use of 80 kV ( P < 0.0001). Diagnostic image quality was maintained, with no significant difference between the 2 groups ( P = 0.887). Conclusion The use of APSCM for coronary CTA significantly reduced radiation dose while maintaining image quality; therefore, it is feasible in daily practice which covers patients with various BMI values.