State-of-the-art in CT hardware and scan modes for cardiovascular CT

Halliburton, Sandra S.; Arbab‐Zadeh, Armin; Dey, Damini; Einstein, Andrew J.; Gentry, Ralph; George, Richard Т. De; Gerber, Thomas C.; Mahesh, Mahadevappa; Weigold, Wm. Guy

doi:10.1016/j.jcct.2012.04.005

Cited by 72 publications

(44 citation statements)

References 47 publications

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“…CTA has made great strides in a short period of time through software, hardware, and protocol advances. 39 Prospective ECG-triggered scanning instead of retrospectively ECG-gated helical scanning, iterative image reconstruction software, dual-source scanners, reducing tube potential, tube current modulation, and decreasing scan length by reducing z-overscanning are all techniques which are employed with increasing frequency even in the short time since the end of this study period. 40 CTA can now be performed in selected patients with effective doses of 1-2 mSv.…”

Section: 6mentioning

confidence: 99%

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

Duvall

Savino

Levine

et al. 2014

Journal of Nuclear Cardiology

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Background. Recent studies have compared CTA to stress testing and MPI using older Na-I SPECT cameras and traditional rest-stress protocols, but are limited by often using optimized CTA protocols but suboptimal MPI methodology. We compared CTA to stress testing with modern SPECT MPI using high-efficiency CZT cameras and stress-first protocols in an ED population.Methods. In a retrospective, non-randomized study, all patients who underwent CTA or stress testing (ETT or Tc-99m sestamibi SPECT MPI) as part of their ED assessment in 2010-2011 driven by ED attending preference and equipment availability were evaluated for their disposition from the ED (admission vs discharge, length of time to disposition), subsequent visits to the ED and diagnostic testing (within 3 months), and radiation exposure. CTA was performed using a 64-slice scanner (GE Lightspeed VCT) and MPI was performed using a CZT SPECT camera (GE Discovery 530c). Data were obtained from prospectively acquired electronic medical records and effective doses were calculated from published conversion factors. A propensity-matched analysis was also used to compare outcomes in the two groups.Results. A total of 1,458 patients underwent testing in the ED with 192 CTAs and 1,266 stress tests (327 ETTs and 939 MPIs). The CTA patients were a lower-risk cohort based on age, risk factors, and known heart disease. A statistically similar proportion of patients was discharged directly from the ED in the stress testing group (82% vs 73%, P 5 .27), but their time to disposition was longer (11.0 ± 5 vs 20.5 ± 7 hours, P < .0001). There was no significant difference in cardiac return visits to the ED (5.7% CTA vs 4.3% stress testing, P 5 .50), but more patients had follow-up studies in the CTA cohort compared to stress testing (14% vs 7%, P 5 .001). The mean effective dose of 12.6 ± 8.6 mSv for the CTA group was higher (P < .0001) than 5.0 ± 4.1 mSv for the stress testing group (ETT and MPI). A propensity score-matched cohort showed similar results to the entire cohort.Conclusions. Stress testing with ETT, high-efficiency SPECT MPI, and stress-only protocols had a significantly lower patient radiation dose and less follow-up diagnostic testing than CTA with similar cardiac return visits. CTA had a shorter time to disposition, but there was a trend toward more revascularization than with stress testing. (J Nucl Cardiol 2014;21:305-18.)

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Section: 6mentioning

confidence: 99%

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

Duvall

Savino

Levine

et al. 2014

Journal of Nuclear Cardiology

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“…Also, the second generation scanner could produce a high tube current when low tube potential was used, thus images with similar contrast to noise ratios could be reconstructed with lower radiation dose. This allows better temporal uniformity of the image including more uniform contrast enhancement and the absence of misalignment artefacts in the z-direction (19). The second generation 320 detector-row scanner by permitting higher proportion of patients (46/50) with elevated heart rate to be imaged with one heart-beat acquisitions improved the overall image quality while maintaining low radiation in our study.…”

Section: Discussionmentioning

confidence: 84%

Superior CT Coronary Angiography Image Quality at Lower Radiation Exposure with Second Generation 320-Detector-Row CT in Patients with Elevated Heart Rate – A Comparison with First Generation 320-Detector-Row CT

Soh

Wong

et al. 2013

Heart, Lung and Circulation

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Background: This study aims to compare the image quality of second generation versus first generation 320-computed tomography coronary angiography (CTCA) in patients with heart rate ≥65 bpm as it has not been specifically reported.Methods: Consecutive patients who underwent CTCA using second-generation-320-detector-row-CT were prospectively enrolled. A total of 50 patients with elevated (≥65 bpm) heart rate and 50 patients with controlled (<65 bpm) heart rate were included. Age and gender matched patients who were scanned with the first-generation-320-detector-row-CT were retrospectively identified. Image quality in each coronary artery segment was assessed by two blinded CT angiographers using the five-point Likert scale.Results: In the elevated heart rate cohorts, while there was no significant difference in heart rate during scan-acquisition (66 vs. 69 bpm, P=0.308), or body mass index (28.5 vs. 29.6, P=0.464), the second generation scanner was associated with better image quality (3.94±0.6 vs. 3.45±0.8, P=0.001), and with lower radiation (2.8 vs. 4.3 mSv, P=0.009). There was no difference in scan image quality for the controlled heart rate cohorts. Conclusions:The second generation CT scanner provides better image quality at lower radiation dose in patients with elevated heart rate (≥65 bpm) compared to first generation CT scanner.

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“…From the introduction of 2-slice CT scanners through the first generation of 64-slice scanners, the main manufacturers of CT scanners offered products with similar technical specifications. However, over the past 5 years, CT hardware design has diverged, with fundamental differences among scanners in terms of the number of x-ray sources, detector geometry, and gantry rotation time [6,8]. Because of these significant advances in CT technology it is likely that future scanners will enable improved image quality under more robust conditions, more imaging applications, and lower doses of radiation.…”

Section: Discussionmentioning

confidence: 99%

“…Because of these significant advances in CT technology it is likely that future scanners will enable improved image quality under more robust conditions, more imaging applications, and lower doses of radiation. Technical progress has enabled the continued growth of cardiovascular CT and has expanded its diagnostic and prognostic benefits [7,8].…”

Section: Discussionmentioning

confidence: 99%

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High Definition Angiography for the Evaluation of Carotid Arteries in Stroke Patients

Aktaş¹,

Yılmaz²,

Kayan³

et al. 2016

Ann Clin Anal Med

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ÖzetGiriş: Yüksek çözünürlüklü (YÇ) Bilgisayarlı Tomografi (BT) invitro damar ve stentlerin kenarlarında netlik artışına neden olduğu bilinen BT teknolojisinde bir gelişme olarak sunuldu. Amacımız, inme hastalarında karotis damarların çapı ve duvar kalınlığını değerlendirerek bu teknolojinin etkinliğini araştır-maktır. Gereç ve Yöntem: BT Anjiyografi (BTA) karotis arter; 19 YÇBT ile 21 standart çözünürlüklü (SÇ) BT toplam 40 inme hastası aynı görüntüleme protokolleri ile farklı üniversite hastanelerinde tetkik edildi. Damar duvarı iç -dış çapları ve ortak, iç,dış karotid arterlerin (CCA, ICA ve ECA) duvar kalınlığı iki radyolog tarafından ölçüldü ve görüntüler kalitesi, hareket artefaktı ve gürül-tüsü açısından karşılaştırıldı. Bulgular: YÇ ve SÇ BT anjiyografi karşılaştırıla-bilir bulunmuştur. YÇBT ölçümlerinde radyologların uyumu ve Cronbach Alpha değeri daha yüksek olup damar konturlarının görüntülerde keskin ve ölçümle-rin daha güvenilir olduğu gösterilmiştir. Tartışma: Teknolojik gelişmeler sonucu görüntü kalitesi YÇBT aniyografide iyileştirilmiştir. Bu yüzden işlem önce-si karotis ostiumundaki plakları , damar duvarının kenarlarını göstermede ve stenoz ölçümünde SÇBT den daha etkili olduğu düşünülmüştür. Anahtar KelimelerYüksek Çözünürlük; Bilgisayarlı Tomografi; Carotid Damarlar; Anjiografi; Gö-rüntü Kalitesi Abstract Aim: High definition(HD) Computed Tomography(CT) was presented as an improvement in CT technology which is known to have increased in sharpness of the edges of the vessels and stents in vitro. The purpose of the study was to take the effectivity of this technology clinically by evaluating the diameter and wall thickness of carotid vessels in stroke patients. Material and Method: CT Angiography(CTA) of carotid arteries; 19 with HDCT and 21 with standard definition(SD) CT, totally 40 stroke patients were examined in different University hospitals with the same imaging protocols. The vessel wall inner and outer diameters and thickness of common, internal and external carotid arteries (CCA, ICA and ECA) were assessed by two blinded radiologists. Comparison was made between the scanners for image quality, motion artefacts and image noise. Results: HD and SD CT angiography achieved comparable. The agreement of the radiologists and Cronbach Alpha value was higher in HDCT showing that vessel contours are sharper in HDCT images and measurements are more reliable. Discussion: Due to new gemstone technology image quality was improved in HDCT angiography, is found much more effective than SDCT to show the edges of the vessel wall so qualifies the establishment of the plaques and extent of osteal stenosis.

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State-of-the-art in CT hardware and scan modes for cardiovascular CT

Cited by 72 publications

References 47 publications

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

A comparison of coronary CTA and stress testing using high-efficiency SPECT MPI for the evaluation of chest pain in the emergency department

Superior CT Coronary Angiography Image Quality at Lower Radiation Exposure with Second Generation 320-Detector-Row CT in Patients with Elevated Heart Rate – A Comparison with First Generation 320-Detector-Row CT

High Definition Angiography for the Evaluation of Carotid Arteries in Stroke Patients

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