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Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

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Abstract

Objective

To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol.

Methods

100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated.

Results

Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 ± 1.86 and 11.95 ± 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging.

Conclusion

In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality.

Key Points

• Coronary computed tomographic angiography (CCTA) can be difficult in patients with arrhythmias.

• Prospectively ECG-triggered sequential CCTA is feasible in patients with atrial fibrillation.

• Prospective sequential imaging can improve quality compared with retrospective analysis.

• Prospective sequential imaging decreases radiation exposure by 64 % compared with retrospective mode.

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Acknowledgments

This work has been supported by a grant for Excellent Talents from Beijing city (2001D003034000030) and the International Collaboration Program from the Chinese Ministry of Science and Technology (2010DFB30040).

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Authors and Affiliations

  1. Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No.2, Anzhen Road, Chaoyang District, 100029, Beijing, China

    Lei Xu, Lin Yang & Zhaoqi Zhang

  2. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Yining Wang & Zhengyu Jin

  3. Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China

    Longjiang Zhang & Guangming Lu

Authors
  1. Lei Xu
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  2. Lin Yang
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  3. Zhaoqi Zhang
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  4. Yining Wang
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  5. Zhengyu Jin
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  6. Longjiang Zhang
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  7. Guangming Lu
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Correspondence to Zhaoqi Zhang.

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Xu, L., Yang, L., Zhang, Z. et al. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT. Eur Radiol 23, 1822–1828 (2013). https://doi.org/10.1007/s00330-013-2793-2

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  • DOI: https://doi.org/10.1007/s00330-013-2793-2

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