'University of Sarajevo Faculty of Health Sciences'
Abstract
Objective: This thesis investigates the application of 3D-printing technology for optimising coronary CT angiography (CCTA) protocols using iterative reconstruction (IR) as a dose optimisation strategy. Methods: In phase one, a novel 3D-printed cardiac insert phantom for the Lungman phantom was developed. The attenuation values of the printed phantom were compared to CCTA patients and Catphan® 500 images. In phase two, the printed phantom was scanned at multiple dose levels, and the datasets were reconstructed using different IR strengths. The image quality characteristics were measured to determine the dose reduction potential. In phase three, the influence of IR strengths with low-tube voltage for dose optimisation studies was investigated. The printed phantom and the Catphan® 500 were scanned at different tube currents and voltages. The results were compared to the patient datasets to measure the agreement between the phantoms and patient datasets. Results: In phase one, the attenuation values were consistent between the printed phantom, patient and Catphan® 500 images. In phase two, the results showed that decreasing dose levels had significantly increased the image noise (p<0.001). The application of various IR strengths had yielded a stepwise improvement of noise image quality with a dose reduction potential of up to 40%. In phase three, the results showed a significant interaction between the effects of low-tube voltage and the IR strengths on image quality (all p<0.001) but not the attenuation values. The mean differences were small between the patient-phantom datasets. The optimised CT protocols allowed up to 57% dose reduction in CCTA protocols while maintaining the image quality. Conclusions: The 3D-printed cardiac insert phantom can be used to evaluate the effect of using IR on dose reduction and image quality. This thesis proposes and validates a new method of developing phantoms for CCTA dose optimisation studies
