Diagnostic Accuracy of Noninvasive Coronary Angiography Using 64-Slice Spiral Computed Tomography

Raff, Gilbert; Gallagher, Michael J.; O’Neill, William W.; Goldstein, James A.

doi:10.1016/j.jacc.2005.05.056

Cited by 1,348 publications

(940 citation statements)

References 12 publications

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“…First, the amount of contrast material was not BMI-adapted in concordance with a large body of literature [1][2][3][4]6,8], although suggested by a few previous reports [9,10]. However, only the use of a fixed amount of contrast material enabled us to specifically evaluate the influence of BMI on image noise and coronary vessel attenuation.…”

Section: Discussionmentioning

confidence: 92%

“…Since the implementation of computed tomography coronary angiography (CTCA) with 64 slices, CTCA is an accurate method for noninvasive detection of coronary artery disease [1][2][3][4]. However, radiation exposure to patients and non-diagnostic image quality still remain issues of concern.…”

Section: Introductionmentioning

confidence: 99%

“…Image quality is primarily affected by coronary calcification [1,4,7], motion artifacts [1][2][3]8], body related factors, (i.e. body mass index (BMI), body surface area (BSA)) [9][10][11] or by contrast bolus dilution depending on cardiac output (CO) [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…body mass index (BMI), body surface area (BSA)) [9][10][11] or by contrast bolus dilution depending on cardiac output (CO) [12][13][14]. Coronary calcifications are known to influence image quality by their blooming and beam-hardening artifacts [1,4,7]. Motion artifacts could be reduced by technical advances in new scanner generations such as subsecond rotation time and 64 [1][2][3] or more slices [15,16], image quality is still affected by individual body-and hemodynamic-related parameters.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Herzog

Husmann

Valenta

et al. 2009

Int J Cardiovasc Imaging

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Methods: Seventy patients underwent low-dose CTCA using BMI-adapted tube parameters and a fixed contrast material bolus. Contrast to noise ratio (CNR) was calculated from contrast (between coronaries and perivascular tissue) and image noise (standard deviation of aortic attenuation). Cardiac output (CO) was calculated from gated 99m Tc-tetrofosmin-SPECT.Results: Mean radiation dose was 2.13 0.69mSv. Image noise was not affected by BMI (r=0.1, P=0.36), while CNR was inversely related to body surface area (BSA) (r= -0.5, P<0.001) and CO (r= -0.49, P<0.001). Conclusions:After successfully overcoming the impact of BMI on image noise by adapting tube parameters, CNR mainly depends on coronary vessel contrast. The latter reflects the dilution of the contrast material by blood volume and CO, which are both correlated to BSA. Therefore, BSA adapted contrast administration may help to compensate for this effect.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Herzog

Husmann

Valenta

et al. 2009

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6] With single-source 64-slice CTA, most investigators recommend lowering the patient's heart rate to G65 beats per minute (bpm) to achieve stable image quality. [7][8][9][10] In this range, diagnostic image quality can be obtained for all coronary arteries at a single reconstruction interval at mid-diastole. 11 When higher heart rates are included however, additional reconstructions at late systole may be required for optimal visualization of the right coronary artery.…”

Section: Introductionmentioning

confidence: 99%

Is It Possible to Predict Heart Rate and Range during Enhanced Cardiac CT Scan from Previous Non-enhanced Cardiac CT?

et al. 2010

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The effect of heart rate and variation during cardiac computed tomography (CT) on the examination quality. The purpose of this study is to investigate whether it is possible to predict heart rate and range during enhanced cardiac computed CT scan from previous non-enhanced cardiac CT scan. Electrocardiograph (ECG) files from 112 patients on three types of cardiac 64-slice CT (nonenhanced, prospective ECG-triggered and retrospective ECG-gated enhanced scans) were recorded. The mean heart rate, range (defined as difference between maximal and minimal heart rates) and the range ratio (defined as maximal heart rate divided by minimal heart rate) during the scans were compared. Scan time was 4.8, 4.6, and 7.3 s on non-enhanced, prospective ECG-triggered and retrospective ECG-gated scans, respectively (pG0.0001). The heart rates were not significantly different (60±9 beats per minute (bpm), 60±9 and 61±10 bpm; p=0.64). Heart rate on the enhanced scan markedly correlated with that of the non-enhanced scan (r=0.78 and 0.74). In contrast, the ranges of heart rate were 2±5, 4±8, and 8± 21 bpm, with different range ratios (1.04, 1.07, and 1.14; pG0.0001). Correlation of heart rate ranges between nonenhanced scan versus prospective ECG-triggered scan was low (r=0.27) and that between non-enhanced scan versus retrospective ECG-gated scan negligible (r= −0.027).Heart rate on enhanced cardiac CT, in most cases, can be predicted from a non-enhanced scan. Heart rate range on enhanced cardiac CT, however, is hard to predict from the non-enhanced scan.

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Radiation Protection of Patients Undergoing Cardiac Computed Tomographic Angiography

Einstein

2009

JAMA

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Diagnostic Accuracy of Noninvasive Coronary Angiography Using 64-Slice Spiral Computed Tomography

Abstract: Our results indicate high quantitative and qualitative diagnostic accuracy of 64-slice MSCT in comparison to QCA in a broad spectrum of patients.

Cited by 1,348 publications

References 12 publications

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Determinants of vessel contrast in BMI-adapted low dose CT coronary angiography with prospective ECG-triggering

Is It Possible to Predict Heart Rate and Range during Enhanced Cardiac CT Scan from Previous Non-enhanced Cardiac CT?

Radiation Protection of Patients Undergoing Cardiac Computed Tomographic Angiography

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