Literature DB >> 18519548

Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance.

H Scheffel1, H Alkadhi, S Leschka, A Plass, L Desbiolles, I Guber, T Krauss, J Gruenenfelder, M Genoni, T F Luescher, B Marincek, P Stolzmann.   

Abstract

OBJECTIVE: To investigate the performance of low-dose, dual-source computed tomography (DSCT) coronary angiography in the step-and-shoot (SAS) mode for the diagnosis of significant coronary artery stenoses in comparison with conventional coronary angiography (CCA). DESIGN, SETTING AND PATIENTS: Prospective, single-centre study conducted in a referral centre enrolling 120 patients (71 men, mean (SD) age 68 (9) years, mean (SD) body mass index 26.2 (3.2) kg/m2). All study participants underwent DSCT in the SAS mode and CCA within 14 days. Twenty-seven patients were given intravenous beta blockers for heart rate reduction before CT. Patients were excluded if a target heart rate <or=70 bpm could not be achieved by beta blockers or when the patients were in non-sinus rhythm. Two blinded readers independently evaluated coronary artery segments for assessability and for the presence of significant (>50%) stenoses. Sensitivity, specificity, negative (NPV) and positive predictive values (PPV) were determined, with CCA being the standard of reference. Radiation dose values were calculated.
RESULTS: DSCT coronary angiography in the SAS mode was successfully performed in all 120 patients. Mean (SD) heart rate during scanning was 59 (6) bpm (range 44-69). 1773/1803 coronary segments (98%) were depicted with a diagnostic image quality in 109/120 patients (91%). The overall patient-based sensitivity, specificity, PPV and NPV for the diagnosis of significant stenoses were 100%, 93%, 94% and 100%, respectively. The mean (SD) effective dose of the CT protocol was 2.5 (0.8) mSv (range 1.2-4.4).
CONCLUSIONS: DSCT coronary angiography in the SAS mode allows, in selected patients with a regular heart rate, the accurate diagnosis of significant coronary stenoses at a low radiation dose.

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Year:  2008        PMID: 18519548     DOI: 10.1136/hrt.2008.149971

Source DB:  PubMed          Journal:  Heart        ISSN: 1355-6037            Impact factor:   5.994


  91 in total

Review 1.  Diagnostic value of coronary CT angiography with prospective ECG-gating in the diagnosis of coronary artery disease: a systematic review and meta-analysis.

Authors:  Zhonghua Sun; Kwan-Hoong Ng
Journal:  Int J Cardiovasc Imaging       Date:  2012-01-04       Impact factor: 2.357

2.  Evidence for prospective ECG-triggering coronary CT angiography in routine practice.

Authors:  Ali Salavati; Frank J Rybicki
Journal:  Int J Cardiovasc Imaging       Date:  2012-02-09       Impact factor: 2.357

3.  Dual-step prospective ECG-triggered 128-slice dual-source CT for evaluation of coronary arteries and cardiac function without heart rate control: a technical note.

Authors:  Gudrun Feuchtner; Robert Goetti; Andrè Plass; Stephan Baumueller; Paul Stolzmann; Hans Scheffel; Monika Wieser; Borut Marincek; Hatem Alkadhi; Sebastian Leschka
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Review 4.  Radiation dose of cardiac computed tomography - what has been achieved and what needs to be done.

Authors:  Hatem Alkadhi; Sebastian Leschka
Journal:  Eur Radiol       Date:  2010-10-19       Impact factor: 5.315

Review 5.  Low dose CT of the heart: a quantum leap into a new era of cardiovascular imaging.

Authors:  E Maffei; C Martini; S De Crescenzo; T Arcadi; A Clemente; E Capuano; A Rossi; R Malagò; N Mollet; A Weustink; C Tedeschi; L La Grutta; S Seitun; A Igoren Guaricci; F Cademartiri
Journal:  Radiol Med       Date:  2010-06-23       Impact factor: 3.469

6.  Dose and image quality comparison between prospectively gated axial and retrospectively gated helical coronary CT angiography.

Authors:  C Hlaihel; L Boussel; H Cochet; J A Roch; P Coulon; M J Walker; P C Douek
Journal:  Br J Radiol       Date:  2011-01       Impact factor: 3.039

7.  Radiation dose reduction in computed tomography: techniques and future perspective.

Authors:  Lifeng Yu; Xin Liu; Shuai Leng; James M Kofler; Juan C Ramirez-Giraldo; Mingliang Qu; Jodie Christner; Joel G Fletcher; Cynthia H McCollough
Journal:  Imaging Med       Date:  2009-10

8.  Plaque imaging with CT coronary angiography: Effect of intra-vascular attenuation on plaque type classification.

Authors:  Erica Maffei; Chiara Martini; Teresa Arcadi; Alberto Clemente; Sara Seitun; Alessandra Zuccarelli; Tito Torri; Nico R Mollet; Alexia Rossi; Onofrio Catalano; Giancarlo Messalli; Filippo Cademartiri
Journal:  World J Radiol       Date:  2012-06-28

9.  Evaluation of an iterative model-based reconstruction algorithm for low-tube-voltage (80 kVp) computed tomography angiography.

Authors:  Peter B Noël; Thomas Köhler; Alexander A Fingerle; Kevin M Brown; Stanislav Zabic; Daniela Münzel; Bernhard Haller; Thomas Baum; Martin Henninger; Reinhard Meier; Ernst J Rummeny; Martin Dobritz
Journal:  J Med Imaging (Bellingham)       Date:  2014-10-09

10.  Body physique and heart rate variability determine the occurrence of stair-step artefacts in 64-slice CT coronary angiography with prospective ECG-triggering.

Authors:  Lars Husmann; Bernhard A Herzog; Nina Burkhard; Fuminari Tatsugami; Ines Valenta; Oliver Gaemperli; Christophe A Wyss; Ulf Landmesser; Philipp A Kaufmann
Journal:  Eur Radiol       Date:  2009-02-24       Impact factor: 5.315

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