Radiation Dose Reduction in Coronary Computed Tomography Angiography: A Reproducibility and Expansion Study

Background: Limiting the harms of ionizing radiation using dose reduction techniques in coronary computed tomography angiography (CCTA) is paramount in evaluating coronary artery disease. Project Rationale: Assess the reproducibility of a CCTA radiation dose reduction strategy using patient-centric standardized computed tomography scanner protocol library and objectively evaluate the impact of protocol changes on image quality. Project Summary: There was a 51.4% reduction postintervention in CCTA radiation dose at the main academic campus (n = 157), 4.6 vs 2.3 mSv, P < 0.0001. There was no significant difference in image quality except higher image noise postintervention. At a new urban satellite campus (n = 281), median radiation dose was 1.99 mSv (IQR: 1.43-3.28). An established rural satellite campus (n = 156) demonstrated median radiation dose, 10.5 mSv (IQR: 8.9-12.2). Take-Home Message: Patient-centric standardized CCTA scan protocols and team collaboration combined with objective computed tomography image quality metrics enables reproducible, multicampus radiation dose reduction and directly bridges clinical performance with evidence to justify essential equipment upgrades.