Wei Wang1, Yan E Zhao2, Li Qi3, Xie Li4, Chang Sheng Zhou5, Long Jiang Zhang6, Guang Ming Lu7. 1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: wangzimo1984@163.com. 2. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: zhaoyk1981@sina.com. 3. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: qili5270@126.com. 4. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: 849049724@qq.com. 5. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: njzhouyisheng@qq.com. 6. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: kevinzhlj@163.com. 7. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China. Electronic address: cjr.luguangming@vip.163.com.
Abstract
PURPOSE: To investigate image quality, radiation dose, and diagnostic efficiency of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp with 30mL contrast agent intra-individually compared with routine CCTA protocol. MATERIALS AND METHODS: One hundred and thirty eight patients with suspected coronary artery disease, body mass index (BMI)≤25kg/m2 and heart rate (HR)≤70 beats per minute (bpm) underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp and 30mL contrast agent (protocol A) and prospectively ECG-triggered sequential scanning at 120 kVp and 60mL contrast medium (protocol B). Objective and subjective image quality, radiation doses, and diagnostic accuracy were evaluated and compared between the two protocols. RESULTS:Higher CT attenuation, higher noise, lower signal-to-noise ratios (SNRs) and lower contrast-to-noise ratios (CNRs) were found in protocol A than in protocol B (P<0.001). However, image quality of protocol A were diagnostic. In patients with BMI<23kg/m2 or HR<60bpm, subjective image quality scores of some coronary arteries in protocol A were not significantly different from protocol B (P>0.05). Effective dose in protocol A has reduced by 96.7% compared with protocol B (P<0.001). No significant differences were found for diagnostic accuracy between the two protocols on a per-segment (P=0.513), per-vessel (P=0.317) and per-patient (P=0.125) basis. CONCLUSIONS: Prospectively ECG-triggered high-pitch CCTA at 70kVp with 30mL contrast agent can reduce radiation dose but maintain image quality and high diagnostic accuracy in a selected, non-obese population.
RCT Entities:
PURPOSE: To investigate image quality, radiation dose, and diagnostic efficiency of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp with 30mL contrast agent intra-individually compared with routine CCTA protocol. MATERIALS AND METHODS: One hundred and thirty eight patients with suspected coronary artery disease, body mass index (BMI)≤25kg/m2 and heart rate (HR)≤70 beats per minute (bpm) underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp and 30mL contrast agent (protocol A) and prospectively ECG-triggered sequential scanning at 120 kVp and 60mL contrast medium (protocol B). Objective and subjective image quality, radiation doses, and diagnostic accuracy were evaluated and compared between the two protocols. RESULTS: Higher CT attenuation, higher noise, lower signal-to-noise ratios (SNRs) and lower contrast-to-noise ratios (CNRs) were found in protocol A than in protocol B (P<0.001). However, image quality of protocol A were diagnostic. In patients with BMI<23kg/m2 or HR<60bpm, subjective image quality scores of some coronary arteries in protocol A were not significantly different from protocol B (P>0.05). Effective dose in protocol A has reduced by 96.7% compared with protocol B (P<0.001). No significant differences were found for diagnostic accuracy between the two protocols on a per-segment (P=0.513), per-vessel (P=0.317) and per-patient (P=0.125) basis. CONCLUSIONS: Prospectively ECG-triggered high-pitch CCTA at 70kVp with 30mL contrast agent can reduce radiation dose but maintain image quality and high diagnostic accuracy in a selected, non-obese population.
Authors: D Seppelt; C Kolb; J P Kühn; U Speiser; C G Radosa; S Hoberück; R T Hoffmann; I Platzek Journal: Int J Cardiovasc Imaging Date: 2019-03-08 Impact factor: 2.357
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