A novel ultrafast-low-dose computed tomography protocol allows concomitant coronary artery evaluation and lung cancer screening

Gaudio, Carlo; Petriello, Gennaro; Pelliccia, Francesco; Tanzilli, Alessandra; A, Bandiera; Tanzilli, Gaetano; Barillà, Francesco; Paravati, Vincenzo; Pellegrini, Massimo; Madon, E; P, Barillari

doi:10.1186/s12872-018-0830-4

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…This study was designed to test the equivalence of the combined cardiac and lung CT protocol vs. conventional cardiac CT protocol with Δ = 15% on the basis of previous observations 6 . Sample size calculation was performed at time of study design in order to avoid any “ post-hoc ” power calculation.…”

Section: Methodsmentioning

confidence: 99%

“…We recently proposed a CT protocol for the simultaneous screening of CAD and lung cancer in those subjects who are deemed to be at high risk for the two conditions 6 . Our preliminary data obtained from 30 subjects showed that the new protocol reliably allows concomitant cardiac and lung CT scanning, thus avoiding to double the doses of radiation and contrast dye which are used when two distinct examinations are performed to study the coronary arteries and the pulmonary areas.…”

Section: Introductionmentioning

confidence: 99%

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Concomitant screening of coronary artery disease and lung cancer with a new ultrafast-low-dose Computed Tomography protocol: A pilot randomised trial

Gaudio

Tanzilli

Mei

et al. 2019

Sci Rep

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We performed a pilot randomised study to assess the feasibility and radiation exposure of a new computed tomography (CT) protocol that allows screening of both coronary artery disease (CAD) and lung cancer. Current or former heavy smokers at high lung cancer risk with indication to cardiac CT for suspected or known CAD were randomised to undergo concomitant CT evaluation of either cardiac or thoracic area or cardiac CT only. Out of 129 subjects deemed eligible for the study, 110 agreed to participate and were randomised to simultaneous cardiac and lung CT (Gr.A; n = 55) or cardiac CT only (Gr.B; n = 55). The feasibility (i.e. adequate visualization of coronary artery segments) was noninferior with simultaneous cardiac and lung CT compared with the standard cardiac CT (870 of 889 segments [97%] in Gr.A vs 878/890 segments [99%] in Gr.B; mean difference 2.0% [90% confidence interval: −0.3% to 4.1%]). The safety (i.e. effective radiation dose) of the concomitant cardiac and lung CT protocol was noninferior to the standard cardiac CT (1.5 [95% confidence intervals: 1.2–1.7] vs. 1.4 [95% confidence intervals: 1.1–1.6] mSv; mean difference 0.1 mSv [90% confidence interval: −0.2 to 0.3 mSv]). In the two groups, a total of 25 significant (>70%) coronary stenoses were found at cardiac CT (9/55 cases of Gr.A vs 11/55 cases of Gr.B). Pulmonary nodules >2 mm were detected in 7 of the 55 Gr.A subjects. This pilot randomised study shows that concomitant CAD and lung cancer screening by means of a new CT protocol is both feasible and safe, thus allowing a comprehensive evaluation of both cardiac and thoracic regions during one CT scanning only. (ClinicalTrials.gov Identifier: NCT03727958).

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Concomitant screening of coronary artery disease and lung cancer with a new ultrafast-low-dose Computed Tomography protocol: A pilot randomised trial

Gaudio

Tanzilli

Mei

et al. 2019

Sci Rep

Self Cite

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Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain

Tresoldi¹,

Ravelli

Sbaraini

et al. 2018

Insights Imaging

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ObjectivesTo assess the computed tomography coronary angiography (CTCA) accuracy for demonstrating possible non-cardiovascular causes of non-acute retrosternal chest pain in patients without known coronary artery disease (CAD) and to correlate CTCA results with the patient management and relief from pain.MethodsThis prospective observational study was approved by the ethical committee. Consecutive patients suffering non-acute chest pain who underwent CTCA and with not known CAD were enrolled and classified as having coronary diseases (CD) or extracardiac diseases (ECD). Association between age, sex, body mass index (BMI), cardiovascular risk factors, and type of chest pain with CD or ECD was estimated. Correlation between BMI classes and each risk factor was also calculated.ResultsA total of 106 patients (60 males; age 62 ± 14 years [mean ± standard deviation]; mean BMI 27) were enrolled. Hypertension was found in 71/106 (67%); smoking was significantly more frequent among males (p = 0.003) and hypercholesterolemia among females (p = 0.017); hypertension and hypercholesterolemia significantly correlated with age, and hypertension also with BMI. Pain was atypical in 70/106 (66%) patients. The kind of pain did not correlate with disease or gender. CTCA showed possible causes of chest pain in 69/106 (65%) patients; 32/69 (47%) having only CD, 23/69 (33%) only ECD, and 14/69 (20%) both CD and ECD. Prevalence was: hiatal hernia 35/106 (33%); significant CAD 24/106 (23%); myocardial bridging 22/106 (21%). At follow-up of 94/106 (89%) patients, 71/94 (76%) were pain-free, 14/17 (82%) significant CAD had been treated, and only one patient with non-significant CAD was treated after CTCA.ConclusionCTCA suggested possible causes of non-acute pain in 65% of patients.Main messages• CTCA can either rule in or rule out possible causes of chest pain alternative to CAD.• Clinically relevant findings were detected in 65% of patients with non-acute chest pain.• Non-cardiovascular diseases potentially explained symptoms in 35% of patients.

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A case of anomalous aortic origin of coronary arteries from the opposite sinus

Tanzilli¹,

Griffo²,

Capasso³

et al. 2020

J Cardiovasc Med Cardiol

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Anomalous Aortic Origin of Coronary Arteries (AAOCA) is a congenital heart defect in which one coronary artery arises from the opposite sinus of Valsalva. AAOCA is observed in approximately 0.3-1.3% of patients undergoing diagnostic Invasive Coronary Angiography (ICA). Among AAOCA, anomalous origin of the left coronary artery from the right sinus of Valsalva is a relatively uncommon fi nding, with a reported prevalence of 0.02%-0.05% on angiographic studies. This AAOCA is the second most common cause of death in young athletes and usually occurs during exertion. Several imaging modalities have been proposed for AAOCA identification and evaluation. Multidetector Computed Tomography (MDCT) may not only visualize AAOCA but better define, as compared with ICA, the origin and course of the anomalous vessel. We report a case of a 19 years old young athlete with anomalous origin of the Left Main Coronary Artery (LMCA) from the right sinus of Valsalva that was detected by MDCT using prospective ECG gating and low-radiation exposure.

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A novel ultrafast-low-dose computed tomography protocol allows concomitant coronary artery evaluation and lung cancer screening

Cited by 4 publications

References 22 publications

Concomitant screening of coronary artery disease and lung cancer with a new ultrafast-low-dose Computed Tomography protocol: A pilot randomised trial

Concomitant screening of coronary artery disease and lung cancer with a new ultrafast-low-dose Computed Tomography protocol: A pilot randomised trial

Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain

A case of anomalous aortic origin of coronary arteries from the opposite sinus

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