Abstract:
BACKGROUND:Arrhythmia during coronary computed tomography angiography (coronary CTA) acquisition increases the risk of nondiagnostic segments and high radiation exposure. An advanced arrhythmia rejection algorithm for prospectively electrocardiogram (ECG)-triggered axial scans using dual-source CT (DSCT) examinations has recently been reported. OBJECTIVE:We compared image quality and effective dose at DSCT examinations using prospectively ECG-triggered axial scanning with advanced arrhythmia rejection software (PT-AAR) versus retrospectively ECG-gated helical scanning with tube-current modulation (RG-TCM) during arrhythmia. METHODS:This was a retrospective case-control study of 90 patients (43 PT-AAR, 47 RG-TCM) with arrhythmia (defined as heart rate variability [HRV] > 10 beats/min during data acquisition) referred for physician-supervised coronary CTA between April 2010 and September 2011. A subset of 22 cases matched for body mass index, HR, HRV, and other scan parameters was identified. Subjective image quality (4-point scale) and effective dose (dose length product method) were compared. RESULTS:PT-AAR was associated with lower effective dose than RG-TCM (4.1 vs 12.6 mSv entire cohort and 4.3 vs 9.1 mSv matched controls; both P < 0.01). Image quality scores were excellent in both groups (3.9 PT-AAR vs 3.6 RG-TCM) and nondiagnostic segment rates were low (0.1% vs 0.6%). Significantly higher image quality scores were found with PT-AAR in the entire cohort (P < 0.05), and in matched controls with high HRV > 28 beats/min (P < 0.05). CONCLUSIONS:In patients with variable heart rates, prospectively ECG-triggered axial DSCT with arrhythmia rejection algorithm is feasible and can decrease radiation exposure by ∼50% versus retrospectively ECG-gated helical DSCT, with preserved image quality.
journal_name
J Cardiovasc Comput Tomogrjournal_title
Journal of cardiovascular computed tomographyauthors
Lee AM,Engel LC,Shah B,Liew G,Sidhu MS,Kalra M,Abbara S,Brady TJ,Hoffmann U,Ghoshhajra BBdoi
10.1016/j.jcct.2012.04.003subject
Has Abstractpub_date
2012-05-01 00:00:00pages
172-183.e2issue
3eissn
1934-5925issn
1876-861Xpii
S1934-5925(12)00135-9journal_volume
6pub_type
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