Optimisation of coronary angiography on new generation computed tomography scanners

Computed tomography coronary angiography (CTCA) is a first line investigation for patients with suspected coronary artery disease. Its use in the UK is expected to rise significantly following the publication of NICE guidelines in 2016. A recent national audit of radiation dose showed significant variation between the lowest and highest dose scanner, potentially resulting in some patients receiving higher radiation dose than necessary. This research aims to rigorously optimise three of the latest CT scanners from different manufacturers capable of single beat cardiac scans. The goal will be to explore dose saving features of each machine and to reduce the radiation dose as low as possible whilst maintaining diagnostic accuracy.

Principal research questions include:

1. What optimisation programs have been carried out on these scanners elsewhere, and what dose level have other centres been able to achieve
2. What tools for dose optimisation are available on each machine and how best should they be implemented
3. What dose reduction can each of the three scanners achieve as part of a managed optimisation program
4. How does dose vary depending on patient weight and BMI