Literature DB >> 18796669

Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose.

Paul Stolzmann1, Sebastian Leschka, Hans Scheffel, Tobias Krauss, Lotus Desbiolles, André Plass, Michele Genoni, Thomas G Flohr, Simon Wildermuth, Borut Marincek, Hatem Alkadhi.   

Abstract

PURPOSE: To prospectively investigate computed tomographic (CT) image quality parameters by using different protocols and to calculate radiation dose estimates for noninvasive coronary angiography performed with dual-source CT in the step-and-shoot (SAS) mode.
MATERIALS AND METHODS: This study was local ethics board approved; written informed consent was obtained from all patients. In the preliminary portion of the study, 40 patients underwent CT coronary angiography in the SAS mode: at 100 kV (protocol A) in 22 patients with a body mass index (BMI) of less than 25 kg/m(2) and at 120 kV (protocol B) in 18 patients with a BMI of 25-30 kg/m(2). Both protocols involved use of an attenuation-based tube current and 1 mL of contrast material per kilogram of body weight. The final portion of the study involved 50 additional patients: 21 patients with a BMI of 25-30 kg/cm(2) assigned to protocol B and 29 patients with a BMI of less than 25 kg/cm(2) assigned to protocol C, which was performed with 100 kV, an attenuation-based tube current, and a reduced contrast material dose of 0.8 mL/kg. Image quality was independently assessed. Attenuation in the aorta and coronary arteries and image noise were measured. Radiation dose was estimated.
RESULTS: Mean image noise was similar with protocols A and B. Mean attenuation in the aorta and coronary arteries with protocol A (444 HU) was significantly (P < .001) higher than that with protocol B (358 HU). The reduced contrast material dose in protocol C yielded attenuation similar to that with protocol B. Diagnostic image quality was achieved with all protocols in 1237 (97.9%) of 1264 coronary segments. No significant differences in image quality between the 100- and 120-kV protocols were found. Mean heart rate had a significant effect on motion artifacts (area under receiver operating characteristic curve [AUC] = 0.818; 95% confidence interval [CI]: 0.723, 0.892; P < .001), whereas heart rate variability had a significant effect on stair-step artifacts (AUC = 0.79; 95% CI: 0.687, 0.865; P < .001). The mean estimated effective dose was 1.2 mSv +/- 0.2 for protocols A and C and 2.6 mSv +/- 0.5 for protocol B.
CONCLUSION: Dual-source SAS-mode CT coronary angiography yielded diagnostic image quality for 97.9% of coronary segments at a low radiation dose. (c) RSNA, 2008.

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Year:  2008        PMID: 18796669     DOI: 10.1148/radiol.2483072032

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  90 in total

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6.  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.

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7.  Coronary artery visibility in free-breathing young children with congenital heart disease on cardiac 64-slice CT: dual-source ECG-triggered sequential scan vs. single-source non-ECG-synchronized spiral scan.

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Review 9.  Coronary CT angiography with prospective ECG-triggering: an effective alternative to invasive coronary angiography.

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Journal:  Cardiovasc Diagn Ther       Date:  2012-03

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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