To the Editor: The study by Dr Raff and colleagues1 demonstrated that the implementation of a radiation dose-reduction program for cardiac computed tomography angiography (CCTA) may be effective. In addition, the authors noted that there was no significant change in the median image quality assessment in the control compared with the follow-up period. However, Table 2 indicates an increase in the proportion of studies with poor or nondiagnostic scores from the control period to the follow-up period (4.2% vs 7.7%, respectively). Although the median score of image quality remained unchanged, the observation that approximately 1 in every 13 studies were nondiagnostic in the follow-up period is of concern.
Torres FS, Crean AM, Paul N. Radiation Dose-Reduction Program for Cardiac Computed Tomography Angiography. JAMA. 2009;302(16):1753. doi:10.1001/jama.2009.1512