European Radiology

, Volume 19, Issue 10, pp 2363–2372 | Cite as

Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

  • Jun Horiguchi
  • Chikako Fujioka
  • Masao Kiguchi
  • Hideya Yamamoto
  • Toshiro Kitagawa
  • Shingo Kohno
  • Katsuhide Ito


The purpose of this study was to compare coronary 64-slice CT angiography (CTA) protocols, specifically prospective electrocardiograph (ECG)-triggered and retrospective ECG-gated CT acquisition performed using a tube voltage of 140 kV and 120 kV, regarding intracoronary stent imaging. Coronary artery stents (n = 12) with artificial in-stent restenosis (50% luminal reduction, 40 HU) on a cardiac phantom were examined by CT at heart rates of 50–75 beats per minute (bpm). The subjective visibility of in-stent restenosis was evaluated with a three-point scale (1 clearly visible, 2 visible, and 3 not visible), and artificial lumen narrowing [(inner stent diameter − measured lumen diameter)/inner stent diameter], lumen attenuation increase ratio [(in-stent attenuation − coronary lumen attenuation)/coronary lumen attenuation], and signal-to-noise ratio of in-stent lumen were determined. The effective dose was estimated. The artificial lumen narrowing (mean 43%), the increase of lumen attenuation (mean 46%), and signal-to-noise ratio (mean 7.8) were not different between CT acquisitions (p = 0.12–0.91). However, the visibility scores of in-stent restenosis were different (p < 0.05) between ECG-gated CTA techniques: (a) 140-kV prospective (effective dose 4.6 mSv), 1.6; (b) 120-kV prospective (3.3 mSv), 1.8; (c) 140-kV retrospective (16.4–18.8 mSv), 1.9; and (d) 120-kV retrospective (11.0–13.4 mSv), 1.9. Thus, 140-kV prospective ECG-triggered CTA improves coronary in-stent restenosis visibility at a lower radiation dose compared with retrospective ECG-gated CTA.


Coronary CTA Stent Phantom 


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Jun Horiguchi
    • 1
  • Chikako Fujioka
    • 1
  • Masao Kiguchi
    • 1
  • Hideya Yamamoto
    • 2
  • Toshiro Kitagawa
    • 2
  • Shingo Kohno
    • 1
  • Katsuhide Ito
    • 3
  1. 1.Department of Clinical RadiologyHiroshima University HospitalHiroshimaJapan
  2. 2.Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan
  3. 3.Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan

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