Image Quality and Radiation Exposure With Prospectively ECG-Triggered Axial Scanning for Coronary CT Angiography

Hausleiter, Jörg; Meyer, Tanja; Martuscelli, Eugenio; Spagnolo, Pietro; Yamamoto, Hiroaki; Carrascosa, Patrícia; Anger, Thomas; Lehmkuhl, Lukas; Alkadhi, Hatem; Martinoff, Stefan; Hadamitzky, Martin; Hein, Franziska; Bischoff, Bernhard; Kuse, Miriam; Schömig, Albert; Achenbach, Stephan

doi:10.1016/j.jcmg.2011.12.017

Cited by 160 publications

(73 citation statements)

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“…Radiation dose is directly related to the craniocaudal scan range (24,27), a factor that the physician and technologist must control. Most of the scans were obtained with prospective ECG gating, which not only reduces radiation exposure by approximately 69%-83% over retrospective gating but also preserves image quality (29,30). No scans required fixed tube current retrospective gating.…”

Section: Discussionmentioning

confidence: 99%

Submillisievert Median Radiation Dose for Coronary Angiography with a Second-Generation 320–Detector Row CT Scanner in 107 Consecutive Patients

Chen¹,

Shanbhag²,

Arai³

2013

Radiology

151

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MD Purpose:To (a) use a new second-generation wide-volume 320-detector row computed tomographic (CT) scanner to explore optimization of radiation exposure in coronary CT angiography in an unselected and consecutive cohort of patients referred for clinical purposes and (b) compare estimated radiation exposure and image quality with that from a cohort of similar patients who underwent imaging with a previous first-generation CT system. Materials andMethods:The study was approved by the institutional review board, and all subjects provided written consent. Coronary CT angiography was performed in 107 consecutive patients with a new secondgeneration 320-detector row unit. Estimated radiation exposure and image quality were compared with those from 100 consecutive patients who underwent imaging with a previous first-generation scanner. Effective radiation dose was estimated by multiplying the dose-length product by an effective dose conversion factor of 0.014 mSv/mGy ⋅ cm and reported with size-specific dose estimates (SSDEs). Image quality was evaluated by two independent readers. Results:The mean age of the 107 patients was 55.4 years 6 12.0 (standard deviation); 57 patients (53.3%) were men. The median body mass index was 27.3 kg/m 2 (range, 18.1-47.2 kg/m 2 ); however, 71 patients (66.4%) were overweight, obese, or morbidly obese. A tube potential of 100 kV was used in 97 patients (90.6%), single-volume acquisition was used in 104 (97.2%), and prospective electrocardiographic gating was used in 106 (99.1%). The mean heart rate was 57.1 beats per minute 6 11.2 (range, 34-96 beats per minute), which enabled single-heartbeat scans in 100 patients (93.4%). The median radiation dose was 0.93 mSv (interquartile range [IQR], 0.58-1.74 mSv) with the second-generation unit and 2.67 mSv (IQR, 1.68-4.00 mSv) with the first-generation unit (P , .0001). The median SSDE was 6.0 mGy (IQR, 4.1-10.0 mGy) with the second-generation unit and 13.2 mGy (IQR, 10.2-18.6 mGy) with the first-generation unit (P , .0001). Overall, the radiation dose was less than 0.5 mSv for 23 of the 107 CT angiography examinations (21.5%), less than 1 mSv for 58 (54.2%), and less than 4 mSv for 103 (96.3%). All studies were of diagnostic quality, with most having excellent image quality. Three of four image quality indexes were significantly better with the second-generation unit compared with the first-generation unit. Conclusion:The combination of a gantry rotation time of 275 msec, wide volume coverage, iterative reconstruction, automated exposure control, and larger x-ray power generator of the second-generation CT scanner provides excellent image quality over a wide range of body sizes and heart rates at low radiation doses.q RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Discussionmentioning

confidence: 99%

Submillisievert Median Radiation Dose for Coronary Angiography with a Second-Generation 320–Detector Row CT Scanner in 107 Consecutive Patients

Chen¹,

Shanbhag²,

Arai³

2013

Radiology

151

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“…A pesar del advenimiento de nuevos equipos de TC que han incorporado nuevos tipos de asociación de la adquisición de las imágenes al electrocardiograma (ECG) propio del paciente durante la realización del examen, la mayoría de los barridos actualmente se realizan de las maneras clásicas: el gatillado prospectivo, en que se realizan cortes secuenciales solamente en la fase de interés del ciclo cardiaco, y el gatillado retrospectivo, en que la emisión de rayos X es en forma continua de hélice, generando imágenes en todas las fases del ciclo cardiaco aumentando la dosis de radiación. En este tipo de gatillado puede aplicarse la modulación de corriente, la cual consiste en la modificación del mili-amperaje del tubo de rayos X según las características morfológicas de la zona anatómica a evaluar, lo que provoca que la emisión de rayos X se reduzca 9 . Aparte de este tipo de modulación de dosis, otra técnica utilizada para disminuir la dosis de radiación en AngioTC de coronarias es la modulación asociada al ECG o "ECG Pulsing", en donde la corriente se disminuye en el período sistólico y se imparte la corriente seleccionada por el operador en el momento de la diástole.…”

Section: Optimización De Dosis De Radiación En Angiotc Coronariaunclassified

Calidad de imagen y reducción de dosis en angiotomografía computarizada de arterias coronarias usando protocolo de baja energía

Allende

Araya

et al. 2017

Rev. chil. radiol.

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“…En el estudio PROTECTION II, se documentó una disminución de la dosis de radiación de un 30% mediante una disminución del kilovoltaje del tubo, manteniendo la calidad de la imagen 4 . Finalmente, en el PROTECTION III, se ha conseguido una reducción de dosis del 69%, en pacientes con frecuencias cardiacas bajas y estables mediante el empleo de un protocolo de escaneado axial 5 . Son varias, por tanto, las estrategias que nos permiten reducir la dosis de radiación hasta valores de 3-4 mSv e incluso menores.…”

Section: Algunos Aspectos Técnicos Novedososunclassified

Tomografía computarizada cardiaca: Nuevas aplicaciones de una técnica en evolución

Martı́n¹,

Corros²,

Calvo³

et al. 2015

Archivos de Cardiología de México

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Recibido el 20 de marzo de 2014; aceptado el 23 de octubre de 2014 PALABRAS CLAVETomografía computarizada cardiaca; Coronariografía no invasiva; España Resumen En los últimos años hemos sido testigos del continuo desarrollo de las técnicas de imagen en cardiología. Entre ellas, la tomografía computarizada cardiaca, técnica emergente y en continua evolución. Con la posibilidad actual de realizar estudios con muy baja radiación se han ampliado sus indicaciones más allá de la coronariografía no invasiva.En el presente trabajo de revisión repasamos las novedades técnicas de la tomografía computarizada cardiaca así como sus nuevas aplicaciones. © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Todos los derechos reservados. KEYWORDS Cardiac computed tomography; Non invasive coronariography; Spain Cardiac computed tomography: New applications of an evolving techniqueAbstract During the last years we have witnessed an increasing development of imaging techniques applied in Cardiology. Among them, cardiac computed tomography is an emerging and evolving technique. With the current possibility of very low radiation studies, the applications have expanded and go further coronariographyIn the present article we review the technical developments of cardiac computed tomography and its new applications

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Image Quality and Radiation Exposure With Prospectively ECG-Triggered Axial Scanning for Coronary CT Angiography

Cited by 160 publications

References 22 publications

Submillisievert Median Radiation Dose for Coronary Angiography with a Second-Generation 320–Detector Row CT Scanner in 107 Consecutive Patients

Submillisievert Median Radiation Dose for Coronary Angiography with a Second-Generation 320–Detector Row CT Scanner in 107 Consecutive Patients

Calidad de imagen y reducción de dosis en angiotomografía computarizada de arterias coronarias usando protocolo de baja energía

Tomografía computarizada cardiaca: Nuevas aplicaciones de una técnica en evolución

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