BACKGROUND: The efforts to reduce radiation from cardiac computed tomography (CT) are essential. Using a prospectively triggered, high-pitch dual-source CT protocol, we aim to determine the radiation dose and image quality in patients undergoing pulmonary vein (PV) imaging. METHODS AND RESULTS: In 94 patients (61±9 years; 71% male) who underwent 128-slice dual-source CT (pitch 3.4), radiation dose and image quality were assessed and compared between 69 patients with sinus rhythm and 25 patients with atrial fibrillation. Radiation dose was compared in a subset of 19 patients with prior retrospective or prospectively triggered CT PV scans without high pitch. In a subset of 18 patients with prior magnetic resonance imaging for PV assessment, PV anatomy and scan duration were compared with high-pitch CT. Using the high-pitch protocol, total effective radiation dose was 1.4 (1.3, 1.9) mSv, with no difference between sinus rhythm and atrial fibrillation (1.4 versus 1.5 mSv; P=0.22). No high-pitch CT scans were nondiagnostic or had poor image quality. Radiation dose was reduced with high-pitch (1.6 mSv) compared with standard protocols (19.3 mSv; P<0.0001). This radiation dose reduction was seen with sinus rhythm (1.5 versus 16.7 mSv; P<0.0001) but was more profound with atrial fibrillation (1.9 versus 27.7 mSv; P=0.039). There was excellent agreement of PV anatomy (κ 0.84; P<0.0001) and a shorter CT scan duration (6 minutes) compared with magnetic resonance imaging (41 minutes; P<0.0001). CONCLUSIONS: Using a high-pitch dual-source CT protocol, PV imaging can be performed with minimal radiation dose, short scan acquisition, and excellent image quality in patients with sinus rhythm or atrial fibrillation. This protocol highlights the success of new cardiac CT technology to minimize radiation exposure, giving clinicians a new low-dose imaging alternative to assess PV anatomy.
BACKGROUND: The efforts to reduce radiation from cardiac computed tomography (CT) are essential. Using a prospectively triggered, high-pitch dual-source CT protocol, we aim to determine the radiation dose and image quality in patients undergoing pulmonary vein (PV) imaging. METHODS AND RESULTS: In 94 patients (61±9 years; 71% male) who underwent 128-slice dual-source CT (pitch 3.4), radiation dose and image quality were assessed and compared between 69 patients with sinus rhythm and 25 patients with atrial fibrillation. Radiation dose was compared in a subset of 19 patients with prior retrospective or prospectively triggered CT PV scans without high pitch. In a subset of 18 patients with prior magnetic resonance imaging for PV assessment, PV anatomy and scan duration were compared with high-pitch CT. Using the high-pitch protocol, total effective radiation dose was 1.4 (1.3, 1.9) mSv, with no difference between sinus rhythm and atrial fibrillation (1.4 versus 1.5 mSv; P=0.22). No high-pitch CT scans were nondiagnostic or had poor image quality. Radiation dose was reduced with high-pitch (1.6 mSv) compared with standard protocols (19.3 mSv; P<0.0001). This radiation dose reduction was seen with sinus rhythm (1.5 versus 16.7 mSv; P<0.0001) but was more profound with atrial fibrillation (1.9 versus 27.7 mSv; P=0.039). There was excellent agreement of PV anatomy (κ 0.84; P<0.0001) and a shorter CT scan duration (6 minutes) compared with magnetic resonance imaging (41 minutes; P<0.0001). CONCLUSIONS: Using a high-pitch dual-source CT protocol, PV imaging can be performed with minimal radiation dose, short scan acquisition, and excellent image quality in patients with sinus rhythm or atrial fibrillation. This protocol highlights the success of new cardiac CT technology to minimize radiation exposure, giving clinicians a new low-dose imaging alternative to assess PV anatomy.
Authors: Ritsushi Kato; Lars Lickfett; Glenn Meininger; Timm Dickfeld; Richard Wu; George Juang; Piamsook Angkeow; Jennifer LaCorte; David Bluemke; Ronald Berger; Henry R Halperin; Hugh Calkins Journal: Circulation Date: 2003-04-07 Impact factor: 29.690
Authors: Laurens F Tops; Jeroen J Bax; Katja Zeppenfeld; Monique R M Jongbloed; Hildo J Lamb; Ernst E van der Wall; Martin J Schalij Journal: Heart Rhythm Date: 2005-10 Impact factor: 6.343
Authors: Monique R M Jongbloed; Jeroen J Bax; Hildo J Lamb; Martijn S Dirksen; K Zeppenfeld; Ernst E van der Wall; Albert de Roos; Martin J Schalij Journal: J Am Coll Cardiol Date: 2005-02-01 Impact factor: 24.094
Authors: Demosthenes Katritsis; Mark A Wood; Eleftherios Giazitzoglou; Richard K Shepard; Georgia Kourlaba; Kenneth A Ellenbogen Journal: Europace Date: 2008-02-19 Impact factor: 5.214
Authors: Hugh Calkins; Josep Brugada; Douglas L Packer; Riccardo Cappato; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; David E Haines; Michel Haissaguerre; Yoshito Iesaka; Warren Jackman; Pierre Jais; Hans Kottkamp; Karl Heinz Kuck; Bruce D Lindsay; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Andrea Natale; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Jeremy N Ruskin; Richard J Shemin Journal: Europace Date: 2007-06 Impact factor: 5.214
Authors: Manuel Belgrano; Paola Bregant; Micheline Fute Djoguela; William Toscano; Elena Marchese; Maria A Cova Journal: Radiol Med Date: 2013-12-12 Impact factor: 3.469
Authors: Faris Khan; Javier E Banchs; Joshua B Skibba; Jennifer Grando-Ting; John Kelleman; Harjit Singh; Mario D Gonzalez Journal: J Interv Card Electrophysiol Date: 2015-01-20 Impact factor: 1.900
Authors: Li Xiu Cao; Huan Zhang; Bo Liu; Wen Jie Yang; Yan Yan Zhang; Zi Lai Pan; Fu Hua Yan; Ke Min Chen Journal: Int J Cardiovasc Imaging Date: 2013-05-05 Impact factor: 2.357
Authors: Dietrich Beitzke; Richard Nolz; Sylvia Unterhumer; Christina Plank; Michael Weber; Rüdiger Schernthaner; Veronika Schöpf; Florian Wolf; Christian Loewe Journal: PLoS One Date: 2014-06-11 Impact factor: 3.240
Authors: M Skowerski; I Wozniak-Skowerska; A Hoffmann; S Nowak; T Skowerski; M Sosnowski; A M Wnuk-Wojnar; K Mizia-Stec Journal: BMC Cardiovasc Disord Date: 2018-07-13 Impact factor: 2.298