Chong-Fu Jia1, Jie Zhong2, Xin-Yi Meng3, Xi-Xia Sun1, Zhi-Qiang Yang1, Yu-Jie Zou1, Xiang-Yue Wang1, Shuang Pan1, Da Yin4, Zhao-Qian Wang5. 1. Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, 222#, Zhong Shan Road, Dalian, 116011, Liaoning, China. 2. Invasive Technology Department, Qingdao City Chengyang District People's Hospital, 600#, Chang Cheng Road, Qingdao, 266109, Shandong, China. 3. Radiology Department, Xi'an No. 3 Hospital, 10#, Feng Cheng Road, Xi'an, 710000, Shaanxi, China. 4. Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222#, Zhong Shan Road, Dalian, 116011, Liaoning, China. 5. Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, 222#, Zhong Shan Road, Dalian, 116011, Liaoning, China. wangzhaoqian2000@163.com.
Abstract
OBJECTIVE: To explore the image quality (IQ) and diagnostic value of 70 kVp turbo high-pitch coronary CT angiography (THP-CCTA) using automated tube voltage selection (ATVS) and 30 mL of low-concentration contrast agent. METHODS: Patients who underwent 70 kVp THP-CCTA using ATVS with 30 mL of contrast agent (group A) were prospectively enrolled, and those who underwent conventional CCTA (100/120 kVp, prospective sequential mode with 65-75 mL of contrast agent) (group B) were retrospectively selected for study. IQ was assessed subjectively on a 5-point scale, and diagnostic value was assessed based on invasive coronary angiography as the gold standard. Heart rate (HR), HR fluctuation (HRF), body mass index (BMI), effective radiation dose (ED), and iodine uptake (IU) were recorded. RESULTS: A total of 796 patients (398/398 in groups A/B) were included. Between-group differences in age, gender, BMI, HR, HRF, and IQ values were not significant. The ED/IU values were 0.3 ± 0.1 mSv/9.0 ± 0.0 g and 5.8 ± 1.8 mSv/22.9 ± 1.0 g in groups A and B, respectively (p < 0.01). The sensitivity, specificity, positive and negative predictive values, and accuracy of THP-CCTA for the diagnosis of ≥ 50% stenosis were 94.8%, 97.5%, 92.0%, 98.4%, and 96.9% respectively. The mean HR and coronary calcium score were independent predictors of diagnostic image quality, and the best cutoff values were 71.5 bpm and 444.1 respectively. CONCLUSION: This third-generation dual-source CT imaging modality, a 70-kVp THP-CCTA system using ATVS with 30 mL of low-concentration contrast agent, produces high-quality images with high diagnostic accuracy for significant stenosis, with ultra low ED and IU. This technique was most promising in individuals with an HR < 71.5 bpm and coronary calcium score < 444.1. KEY POINTS: • Turbo high-pitch CCTA using 70 kVp via automated tube voltage selection and 30 mL of low-concentration contrast agent is feasible. • This protocol provides high diagnostic accuracy for significant coronary stenosis and reduces radiation doses and iodine uptake significantly. • This protocol was most promising in individuals with an HR < 71.5 bpm and coronary calcium score < 444.1.
OBJECTIVE: To explore the image quality (IQ) and diagnostic value of 70 kVp turbo high-pitch coronary CT angiography (THP-CCTA) using automated tube voltage selection (ATVS) and 30 mL of low-concentration contrast agent. METHODS:Patients who underwent 70 kVp THP-CCTA using ATVS with 30 mL of contrast agent (group A) were prospectively enrolled, and those who underwent conventional CCTA (100/120 kVp, prospective sequential mode with 65-75 mL of contrast agent) (group B) were retrospectively selected for study. IQ was assessed subjectively on a 5-point scale, and diagnostic value was assessed based on invasive coronary angiography as the gold standard. Heart rate (HR), HR fluctuation (HRF), body mass index (BMI), effective radiation dose (ED), and iodine uptake (IU) were recorded. RESULTS: A total of 796 patients (398/398 in groups A/B) were included. Between-group differences in age, gender, BMI, HR, HRF, and IQ values were not significant. The ED/IU values were 0.3 ± 0.1 mSv/9.0 ± 0.0 g and 5.8 ± 1.8 mSv/22.9 ± 1.0 g in groups A and B, respectively (p < 0.01). The sensitivity, specificity, positive and negative predictive values, and accuracy of THP-CCTA for the diagnosis of ≥ 50% stenosis were 94.8%, 97.5%, 92.0%, 98.4%, and 96.9% respectively. The mean HR and coronary calcium score were independent predictors of diagnostic image quality, and the best cutoff values were 71.5 bpm and 444.1 respectively. CONCLUSION: This third-generation dual-source CT imaging modality, a 70-kVp THP-CCTA system using ATVS with 30 mL of low-concentration contrast agent, produces high-quality images with high diagnostic accuracy for significant stenosis, with ultra low ED and IU. This technique was most promising in individuals with an HR < 71.5 bpm and coronary calcium score < 444.1. KEY POINTS: • Turbo high-pitch CCTA using 70 kVp via automated tube voltage selection and 30 mL of low-concentration contrast agent is feasible. • This protocol provides high diagnostic accuracy for significant coronary stenosis and reduces radiation doses and iodine uptake significantly. • This protocol was most promising in individuals with an HR < 71.5 bpm and coronary calcium score < 444.1.
Authors: Wei-Hua Yin; Bin Lu; Jian-Bo Gao; Pei-Ling Li; Kai Sun; Zhi-Feng Wu; Wen-Jie Yang; Xiao-Qin Zhang; Min-Wen Zheng; Andrew D McQuiston; Felix G Meinel; Uwe Joseph Schoepf Journal: J Cardiovasc Comput Tomogr Date: 2015-01-22
Authors: Georg Apfaltrer; Moritz H Albrecht; U Joseph Schoepf; Taylor M Duguay; Carlo N De Cecco; John W Nance; Domenico De Santis; Paul Apfaltrer; Marwen H Eid; Chelsea D Eason; Zachary M Thompson; Maximilian J Bauer; Akos Varga-Szemes; Brian E Jacobs; Erich Sorantin; Christian Tesche Journal: Eur Radiol Date: 2018-02-05 Impact factor: 5.315
Authors: Wei Wang; Yan E Zhao; Li Qi; Xie Li; Chang Sheng Zhou; Long Jiang Zhang; Guang Ming Lu Journal: Eur J Radiol Date: 2017-02-17 Impact factor: 3.528
Authors: M Koplay; H Erdogan; A Avci; M Sivri; K Demir; I Guler; L S Demir; Y Paksoy Journal: Diagn Interv Imaging Date: 2015-11-21 Impact factor: 4.026
Authors: Mathias Meyer; Holger Haubenreisser; U Joseph Schoepf; Rozemarijn Vliegenthart; Christianne Leidecker; Thomas Allmendinger; Ralf Lehmann; Sonja Sudarski; Martin Borggrefe; Stefan O Schoenberg; Thomas Henzler Journal: Radiology Date: 2014-05-31 Impact factor: 11.105
Authors: Gianluca Pontone; Giuseppe Muscogiuri; Andrea Baggiano; Daniele Andreini; Andrea I Guaricci; Marco Guglielmo; Fabio Fazzari; Saima Mushtaq; Edoardo Conte; Andrea Annoni; Alberto Formenti; Elisabetta Mancini; Massimo Verdecchia; Laura Fusini; Lorenzo Bonfanti; Elisa Consiglio; Mark G Rabbat; Antonio L Bartorelli; Mauro Pepi Journal: J Thorac Imaging Date: 2018-07 Impact factor: 3.000
Authors: Long Jiang Zhang; Li Qi; Carlo N De Cecco; Chang Sheng Zhou; James V Spearman; U Joseph Schoepf; Guang Ming Lu Journal: Medicine (Baltimore) Date: 2014-11 Impact factor: 1.889