Coronary CT angiography with low radiation dose

With the introduction of 64-slice CT and dual-source CT technology, coronary CT angiography (CCTA) has emerged as a useful diagnostic imaging modality for the noninvasive assessment of coronary heart disease. Recently, the risks associated with ionizing radiation on CT have raised serious concerns. The main concern of exposure to ionizing radiation is the potential risk of cancer. CCTA involves much higher radiation dose with the advances in the spatial and temporal resolution of cardiac CT. Currently, various dose-saving algorithms, such as ECG (electrocardiography)-based dose modulation, reduced tube voltage, and prospective ECG gating, high-pitch helical scanning are available to lower radiation exposure during cardiac CT. Therefore, careful selection of CT scanning protocols is needed to keep the radiation exposure ‘as low as reasonably achievable (ALARA)’. In this review we will discuss the radiation dose safety issues, the measurement of radiation dose and current use of dose-saving techniques in CCTA.