Lucas L Geyer1, Carlo Nicola De Cecco2, U Joseph Schoepf3, Justin R Silverman2, Aleksander W Krazinski2, Fabian Bamberg4, Daniel H Steinberg5. 1. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425-2260; Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany. 2. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425-2260. 3. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, Charleston, SC 29425-2260; Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina. Electronic address: schoepf@musc.edu. 4. Department of Radiology, University of Tuebingen, Tuebingen, Germany. 5. Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina.
Abstract
RATIONALE AND OBJECTIVES: To investigate the diagnostic performance of a comprehensive computed tomography (CT) protocol for both cardiac and aortoiliac evaluation of patients considered for transcatheter aortic valve replacement (TAVR) using a single, low-volume contrast medium (CM) injection. MATERIALS AND METHODS: Forty-four TAVR candidates were retrospectively analyzed. All underwent retrospectively electrocardiogram-gated cardiac CT followed by high-pitch CT angiography of the aortoiliac vasculature using one of two single injection protocols of 320 mgI/mL iodine CM: group A (n = 22), iodine delivery rate-based (1.28 gI/s), 60-mL CM volume, 4.0 mL/s flow rate; group B (n = 22), clinical routine protocol, 100-mL CM volume, 4.0 mL/s flow rate. Mean arterial attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed. RESULTS: Aortic root and iliofemoral dimensions could be analyzed in all cases. Patient characteristics showed no significant differences. Mean attenuation at the levels of the aortic root (285.8 ± 83.0 HU vs 327.5 ± 70.8 HU, P = .080) and the iliofemoral access route (256.8 ± 88.5 HU vs 307.5 ± 93.2 HU, P = .071), as well as SNR and CNR were nonsignificantly lower in group A compared to group B. Subjective image quality was equivalent. CONCLUSIONS: In multimorbid TAVR patients, the performance of a combined CT protocol using a single low-volume CM bolus is feasible with maintained image quality compared to a standard protocol.
RATIONALE AND OBJECTIVES: To investigate the diagnostic performance of a comprehensive computed tomography (CT) protocol for both cardiac and aortoiliac evaluation of patients considered for transcatheter aortic valve replacement (TAVR) using a single, low-volume contrast medium (CM) injection. MATERIALS AND METHODS: Forty-four TAVR candidates were retrospectively analyzed. All underwent retrospectively electrocardiogram-gated cardiac CT followed by high-pitch CT angiography of the aortoiliac vasculature using one of two single injection protocols of 320 mgI/mL iodine CM: group A (n = 22), iodine delivery rate-based (1.28 gI/s), 60-mL CM volume, 4.0 mL/s flow rate; group B (n = 22), clinical routine protocol, 100-mL CM volume, 4.0 mL/s flow rate. Mean arterial attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed. RESULTS: Aortic root and iliofemoral dimensions could be analyzed in all cases. Patient characteristics showed no significant differences. Mean attenuation at the levels of the aortic root (285.8 ± 83.0 HU vs 327.5 ± 70.8 HU, P = .080) and the iliofemoral access route (256.8 ± 88.5 HU vs 307.5 ± 93.2 HU, P = .071), as well as SNR and CNR were nonsignificantly lower in group A compared to group B. Subjective image quality was equivalent. CONCLUSIONS: In multimorbid TAVR patients, the performance of a combined CT protocol using a single low-volume CM bolus is feasible with maintained image quality compared to a standard protocol.
Authors: Peter Dankerl; Matthias Hammon; Hannes Seuss; Monique Tröbs; Annika Schuhbaeck; Michaela M Hell; Alexander Cavallaro; Stephan Achenbach; Michael Uder; Mohamed Marwan Journal: Int J Comput Assist Radiol Surg Date: 2016-09-07 Impact factor: 2.924
Authors: Todd C Pulerwitz; Omar K Khalique; Tamim N Nazif; Anna Rozenshtein; Gregory D N Pearson; Rebecca T Hahn; Torsten P Vahl; Susheel K Kodali; Isaac George; Martin B Leon; Belinda D'Souza; Ming Jack Po; Andrew J Einstein Journal: J Cardiovasc Comput Tomogr Date: 2016-03-28
Authors: Damiano Caruso; Russell D Rosenberg; Carlo N De Cecco; Stefanie Mangold; Julian L Wichmann; Akos Varga-Szemes; Daniel H Steinberg; Andrea Laghi; U Joseph Schoepf Journal: Curr Cardiol Rep Date: 2016-02 Impact factor: 2.931