Prospective randomized trial on radiation dose estimates of CT angiography in patients applying Iterative image reconstruction techniques - results of the PROTECTION V study
Bibliographic record
Abstract
Introduction: Despite a significant reduction of radiation dose associated with coronary CT angiography (CCTA) over the last decade, concerns still exist about the radiation exposure and the very low stochastic risk for the development of radiation-induced cancer. Recently, iterative image reconstruction algorithms have been developed by different CT vendors, possibly allowing for reduced tube current leading to lower radiation dose. Objectives: The PROTECTION V study investigates the impact of reduced tube current combined with iterative image reconstruction techniques in comparison to standard cCTA (using standard tube current levels with traditional filtered back projection image reconstruction) on diagnostic image quality and radiation dose. Methods: The PROTECTION V study is an international, prospective, randomized, multi-center, multi-vendor clinical trial. 400 patients were randomized to either one of the groups described above. All participating centres were highly encouraged to use axial image acquisition and other available dose reduction strategies. The primary study end point was to prove non-inferior diagnostic image quality with iterative image reconstruction and reduced tube current in comparison to standard image acquisition (predifined margin of inferiority 0.2). Image quality was assessed using a nominal scale ranging from 1 to 4 - 1 representing non-diagnostic image quality, 4 representing excellent image quality). Secondary study endpoints were radiation dose and the need for downstream testing within 30 days after coronary cCTA. Results: Patient recruitment is complete and data is currently being analysed. Radiation dose is currently available for 166 patients in the conventional group (3.2 mSv) and 171 patients in the group using reduced tube voltage and iterative image reconstruction (2.3 mSv), corresponding to a dose reduction of 28.1%. Full results including image quality, radiation dose and 30 day follow-up for all patients will be presented.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".