European Radiology

, Volume 19, Issue 9, pp 2147–2155

Adequate image quality with reduced radiation dose in prospectively triggered coronary CTA compared with retrospective techniques

  • Elisabeth Arnoldi
  • Thorsten R. Johnson
  • Carsten Rist
  • Bernd J. Wintersperger
  • Wieland H. Sommer
  • Alexander Becker
  • Christoph R. Becker
  • Maximilian F. Reiser
  • Konstantin Nikolaou
Cardiac

DOI: 10.1007/s00330-009-1411-9

Cite this article as:
Arnoldi, E., Johnson, T.R., Rist, C. et al. Eur Radiol (2009) 19: 2147. doi:10.1007/s00330-009-1411-9

Abstract

The goal of our study was to compare a prospective triggering (PT) CT technique with retrospectively gated (RG) CT techniques in coronary computed tomographic angiograms (CCTA) with respect to image quality and radiation dose. Sixty consecutive patients were enrolled. CCTAs using the RG technique were obtained with a dual-source 64-slice CT system in 40 patients, using ECG-triggered tube current modulation, with either a broad pulsing window at 30–80% of the RR interval (group RGb, 20 patients, heart rate > 70 bpm) or a small pulsing window at 70% (group RGs, 20 patients, heart rate < 70 bpm). The other 20 patients underwent CCTA using the PT technique on a 128-slice CT system (group PT, heart rate < 70 bpm). All images were evaluated by two observers for quality on a three-point scale, with 1 being excellent and 3 being insufficient. The effective radiation dose was calculated for each patient. The average image quality score was 1.5 ± 0.6 for PT, 1.35 ± 0.5 for RGs and 1.65 ± 0.5 for RGb. The mean effective dose for RGb was 9 ± 4 mSv, for RGs 7 ± 3 mSv and for PT 3 ± 1 mSv. This represents a 57% dose reduction for PT compared with RGs and a 67% dose reduction for PT compared with RGb. In conclusion, in selected patients CCTA with the PT technique offers adequate image quality with a significantly lower radiation dose compared with CCTA using RG techniques.

Keywords

Coronary CT angiographyProspective triggeringRadiation doseImage qualityCoronary artery disease

Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Elisabeth Arnoldi
    • 1
  • Thorsten R. Johnson
    • 1
  • Carsten Rist
    • 1
  • Bernd J. Wintersperger
    • 1
  • Wieland H. Sommer
    • 1
  • Alexander Becker
    • 2
  • Christoph R. Becker
    • 1
  • Maximilian F. Reiser
    • 1
  • Konstantin Nikolaou
    • 1
  1. 1.Department of Clinical Radiology, University Hospitals Munich—Grosshadern CampusLudwig-Maximilians UniversityMunichGermany
  2. 2.Department of Medicine I, University Hospitals Munich—Grosshadern CampusLudwig-Maximilians UniversityMunichGermany