Predicting success of prospective and retrospective gating with dual-source coronary computed tomography angiography: Development of selection criteria and initial experience

Gutstein, Ariel; Wolak, Arik; Lee, Cynthia; Dey, Damini; Ohba, Muneo; Suzuki, Yasuyuki; Cheng, Victor; Gransar, Heidi; Suzuki, Shoji; Friedman, John D.; Thomson, Louise; Hayes, Sean W.; Pimentel, Raymond; Paz, William; Slomka, Piotr J.; Berman, Daniel S.

doi:10.1016/j.jcct.2007.12.015

Cited by 53 publications

(53 citation statements)

References 17 publications

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“…(2,(5)(6)(7)(8)(9)14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) The attrition diagram for our study depicting the search process is shown in Fig. 2 Table III.…”

Section: Resultsmentioning

confidence: 99%

“…In response to the general concern for the high doses of radiation associated with CCTA, various dose-saving strategies were found to have been introduced in the literature, with the (3,(35)(36)(37) Although the present analysis did not focus on studies using retrospective ECG-gated CCTA, radiation dose reports from previous studies confirm that effective doses were significantly reduced by prospective ECG gating (3.6 mSv) when compared to retrospective ECG gating (18)(19)(20)(21)(22)(23)(24). (23,38) Several other studies on radiation doses also indicate that prospective ECG-gated CCTA leads to a dose reduction of up to 83% when compared to retrospective ECG gating.…”

Section: Figmentioning

confidence: 93%

“…One study was conducted with high pitch values so that the effective dose was less than 1.0 mSv. (7) In other studies, applying a high field of view (FOV > 250 mm, 4.8 mSv vs. FOV < 250 mm, 3.9 mSv) (26) and lowering the tube voltage to 100 kVp (100 kVp, 2.7 mSv vs. 120 kVp, 3.9 mSv) (7,9,14,18,21,22,(29)(30)(31)(32) led to reductions in radiation doses.…”

Section: Systematic Review Of Radiation Dose Associated With Prospectmentioning

confidence: 95%

“…(2,(7)(8)(9)19,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) Two studies used consensus reading. (21,22) However, pertinent information was not available in the remaining five studies that met our selection criteria. (5,6,14,17,18) A Likert rank-scale point score system was used in all studies to indicate the evaluability of the coronary segment.…”

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

“…(2,5,19,25,31) Pooled estimates were determined in these five studies for patient-based assessments (sensitivity 98.3% [95% CI 96.0-100.0]; five studies focused on the location of stenosis and coronary vessel involvement. (7,19,22,26,31) A comparison of data could not be performed among these five studies, as they used divergent methods of analysis, although the sensitivities for detecting stenosis on vessel-based (sensitivity 89.3%) and segment-based (sensitivity 89.8%) assessments were found to be lower than that on patientbased assessment (sensitivity 98.3%). 95% CI 2.9-5.6) was higher in patients with BMI > 25 kg/m 2 than those with BMI < 25 kg/m 2 (3.1 mSv; 95% CI 2.3-3.9).…”

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

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Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Sabarudin

Sun

2013

SMedJ

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Singapore Med J 2013; 54(1) : 15 R ev iew A r tic le INTRODUCTIONCoronary computed tomography angiography (CCTA) has been widely used as a valuable diagnostic imaging modality for the noninvasive assessment of coronary artery disease (CAD). It has become a reliable and accurate modality to assess the coronary arteries of patients with suspected CAD.(1) Previous studies have found that retrospective electrocardiography (ECG)-gated CCTA provides high sensitivity (range 86%-99%) and specificity (range 89%-100%) for coronary artery stenosis, and also results in high negative predictive values (NPVs; range 96%-99%).(2,3)Prospective ECG-gated CCTA also promises high sensitivity (range 93.7%-100.0%), specificity (range 82.7%-97.0%) and NPV (range 95%-98%) in the assessment of CAD. (2,3) Although high diagnostic accuracy is achieved with both retrospective and prospective ECG-gated CCTA for detecting CAD (Fig. 1), the radiation doses associated with these two cardiac examinations are significantly different due to the different approaches used for coronary artery scanning.It is well known that CCTA with retrospective ECG gating leads to high radiation doses of up to 31.4 mSv since volumetric data of the heart is acquired during continuous scans in this modality, although only a portion of the data is used for reconstruction. (4,5) In contrast, with exposure taking place at selective phases of the cardiac cycle in patients with low and regular heart rate, prospective ECG triggering is associated with very low radiation doses, which indicates a significant reduction in effective doses of up to 87%. (6) Several studies that used prospective ECG-gated CCTA have reported significantly reduced radiation doses. (7)(8)(9)(10)(11)(12) However, the diagnostic image quality of prospective triggering in the assessment of coronary arteries or CAD has not been systematically studied. Therefore, the purpose of this study was to investigate previous studies that assessed the coronary artery using prospective ECG-triggered CCTA for the detection of CAD, in terms of image quality and radiation dose via a systematic review of the current literature. METHODS Literature searchA ABSTRACT The purpose of this study was to perform a systematic review of the diagnostic accuracy, image quality and radiation dose of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA). We searched databases containing studies of CCTA that used prospective ECG-triggering between 2008 and 2011. The effective dose and image quality reported in each study were analysed and compared between the types of multislice CT scanners. We identified 23 studies through this search, with mean assessable coronary segments and effective dose at 96.8% (95% confidence level [CI] 83%, 100%) and 3.6 mSv (95% CI 2.9, 4.3 mSv), respectively. Both quantitative and qualitative assessments of image quality indicated that image quality was achieved in studies using prospective ECG-triggered CCTA, regardless of the type of CT scanners. The pooled es...

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“…(2,(5)(6)(7)(8)(9)14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) The attrition diagram for our study depicting the search process is shown in Fig. 2 Table III.…”

Section: Resultsmentioning

confidence: 99%

Section: Figmentioning

confidence: 93%

Section: Systematic Review Of Radiation Dose Associated With Prospectmentioning

confidence: 95%

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

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Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Sabarudin

Sun

2013

SMedJ

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Imaging: Echo, CT and MRI

2017

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Effect of hybrid iterative reconstruction technique on quantitative and qualitative image analysis at 256-slice prospective gating cardiac CT

et al. 2011

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Predicting success of prospective and retrospective gating with dual-source coronary computed tomography angiography: Development of selection criteria and initial experience

Cited by 53 publications

References 17 publications

Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Imaging: Echo, CT and MRI

Effect of hybrid iterative reconstruction technique on quantitative and qualitative image analysis at 256-slice prospective gating cardiac CT

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