S Gang1, L Min, L Li, L Guo-Ying, X Lin, J Qun, Z Hua. 1. Department of Medical Imaging, Jinan Military General Hospital, Jinan, Shandong Province, China. cjr.sungang@vip.163.com
Abstract
OBJECTIVES: The aim of this article was to prospectively evaluate the accuracy and radiation dose of 320-detector row dynamic volume CT (DVCT) for the detection of coronary artery disease (CAD) in a high-risk population. METHODS: 60 patients with a high risk of CAD underwent DVCT without preceding heart rate control and also underwent invasive coronary angiography (ICA), which served as the standard reference. RESULTS: On a per segment analysis, overall sensitivity was 95.3%, specificity was 97.6%, positive predictive value was 90.6%, negative predictive value was 98.8% and Youden index was 0.93. In both heart rate subgroups, diagnostic accuracy for the assessment of coronary artery stenosis was similar. The accuracy of the subgroup with an Agatston score ≥100 was lower than that for patients with an Agatston score <100. However, the difference between DVCT and ICA results was not significant (p=0.08). The mean estimated effective dose of CT was 12.5 ± 9.4 mSv. In those patients with heart rates less than 70 beats per minute (bpm), the mean radiation exposure of DVCT was 5.2 ± 0.9 mSv. The effective radiation dose was significantly lower than that of ICA (14.1 ± 5.9 mSv) (p<0.001). When the heart rate was >70 bpm, a significantly higher dose was delivered to patients with DVCT (22.6 ± 5.2 mSv, p<0.001) than with ICA (15.0 ± 5.3 mSv, p<0.001). CONCLUSION: DVCT reliably provides high diagnostic accuracy without heart rate/rhythm control. However, from a dosimetric point of view, it is recommended that heart rate should be controlled to <70 bpm to decrease radiation dose.
OBJECTIVES: The aim of this article was to prospectively evaluate the accuracy and radiation dose of 320-detector row dynamic volume CT (DVCT) for the detection of coronary artery disease (CAD) in a high-risk population. METHODS: 60 patients with a high risk of CAD underwent DVCT without preceding heart rate control and also underwent invasive coronary angiography (ICA), which served as the standard reference. RESULTS: On a per segment analysis, overall sensitivity was 95.3%, specificity was 97.6%, positive predictive value was 90.6%, negative predictive value was 98.8% and Youden index was 0.93. In both heart rate subgroups, diagnostic accuracy for the assessment of coronary artery stenosis was similar. The accuracy of the subgroup with an Agatston score ≥100 was lower than that for patients with an Agatston score <100. However, the difference between DVCT and ICA results was not significant (p=0.08). The mean estimated effective dose of CT was 12.5 ± 9.4 mSv. In those patients with heart rates less than 70 beats per minute (bpm), the mean radiation exposure of DVCT was 5.2 ± 0.9 mSv. The effective radiation dose was significantly lower than that of ICA (14.1 ± 5.9 mSv) (p<0.001). When the heart rate was >70 bpm, a significantly higher dose was delivered to patients with DVCT (22.6 ± 5.2 mSv, p<0.001) than with ICA (15.0 ± 5.3 mSv, p<0.001). CONCLUSION:DVCT reliably provides high diagnostic accuracy without heart rate/rhythm control. However, from a dosimetric point of view, it is recommended that heart rate should be controlled to <70 bpm to decrease radiation dose.
Authors: S Windecker; W Maier-Rudolph; T Bonzel; G Heyndrickx; J M Lablanche; M C Morice; V Mühlberger; K L Neuhaus; F Piscione; M van den Brand; W Wijns; B Meier Journal: Eur Heart J Date: 1999-04 Impact factor: 29.983
Authors: A Knez; C R Becker; A Leber; B Ohnesorge; A Becker; C White; R Haberl; M F Reiser; G Steinbeck Journal: Am J Cardiol Date: 2001-11-15 Impact factor: 2.778
Authors: Dieter Ropers; Ulrich Baum; Karsten Pohle; Katharina Anders; Stefan Ulzheimer; Bernd Ohnesorge; Christian Schlundt; Werner Bautz; Werner G Daniel; Stephan Achenbach Journal: Circulation Date: 2003-02-11 Impact factor: 29.690
Authors: Alexander W Leber; Andreas Knez; Alexander Becker; Christoph Becker; Franz von Ziegler; Konstantin Nikolaou; Carsten Rist; Maximilian Reiser; Carl White; Gerhard Steinbeck; Peter Boekstegers Journal: J Am Coll Cardiol Date: 2004-04-07 Impact factor: 24.094
Authors: Nitesh Nerlekar; Brian S Ko; Arthur Nasis; James D Cameron; Michael Leung; Adam J Brown; Dennis T L Wong; Philip J Ngu; John M Troupis; Sujith K Seneviratne Journal: Cardiovasc Diagn Ther Date: 2017-06
Authors: Martijn A M den Dekker; Kristof de Smet; Geertruida H de Bock; Rene A Tio; Matthijs Oudkerk; Rozemarijn Vliegenthart Journal: Eur Radiol Date: 2012-07-15 Impact factor: 5.315