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Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients

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Abstract

The purpose of this study was to evaluate image quality of low-dose electrocardiogram (ECG)-gated multislice helical computed tomography (CT) angiograms of the chest. One hundred and five consecutive patients with a regular sinus rhythm (72 men; 33 women) underwent ECG-gated CT angiographic examination of the chest without administration of beta blockers using the following parameters: (a) collimation 32×0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices, rotation time 0.33 s, pitch 0.3; (b) 120 kV, 200 mAs; (c) use of two dose modulation systems, including adjustment of the mAs setting to the patient’s size and anatomical shape and an ECG-controlled tube current. Subjective and objective image quality was evaluated by two radiologists in consensus on 3-mm-thick scans reconstructed at 55% of the response rate (RR) interval. The population and protocol characteristics included: (a) a mean [±standard deviation (SD)] body mass index (BMI) of 24.47 (±4.64); (b) a mean (±SD) heart rate of 72.04 (±15.76) bpm; (c) a mean (±SD) scanning time of 18.3 (±2.73) s; (d) a mean (±SD) dose-length product (DLP) value of 260.57 (±83.67) mGy/cm; (e) an estimated average effective dose of 4.95 (±1.59) mSv. Subjective noise was depicted in a total of nine examinations (8.5%), always rated as mild. Objective noise was assessed by measuring the standard deviation of pixel values in a homogeneous region of interest within the trachea and descending aorta; SD was 15.91 HU in the trachea and 22.16 HU in the descending aorta, with no significant difference in the mean value of the standard deviations between the four categories of BMI except for obese patients, who had a higher mean SD within the aorta. Interpolation artefacts were depicted in 22 patients, with a mean heart rate significantly lower than that of patients without interpolation artifacts, rated as mild in 11 patients and severe in 11 patients. The severity of interpolation artefacts was significantly linked to a low heart rate in affected patients. The overall image quality of CT scans was rated as diagnostic in 94 patients (89.5%) while 11 examinations (10.5%) were found to be partially nondiagnostic owing to the cyclic presence of severe interpolation artefacts, which can be compensated for by additional reconstructions at a different temporal window. In these cases, interpolation artefacts could have been avoided by reducing the pitch from 0.3 to 0.2 at the expense of increased patient dose. Low-dose ECG-gated CT angiograms of the chest can be obtained in routine clinical practice with 64-slice CT technology without altering the diagnostic value of CT scans.

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References

  1. Oldershaw P (1992) Assessment of right ventricular function and its role in clinical practice. Br Heart J 68:12–15

    Article  PubMed  CAS  Google Scholar 

  2. Coche E, Vlassenbroeck A, Roelants V, D’Hoore W, Verschuren F, Goncette L, Maldague B (2005) Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography. Eur Radiol 15:1432–1440

    Article  PubMed  Google Scholar 

  3. Delhaye D, Remy-Jardin M, Teisseire A, Hossein-Foucher C, Leroy S, Duhamel A, Remy J (2005) Estimation of right ventricular ejection fraction by multidetector row CT: comparison with equilibrium radionuclide scintigraphy (Part 1) AJR (in press)

  4. Salem R, Remy-Jardin M, Delhaye D, Khalil C, Teisseire A, Delannoy-Deken V, Duhamel A, Remy J (2005) Integrated cardiothoracic imaging with ECG-gated 64-slice multidetector-row CT: preliminary experience in 133 patients. Eur Radiol DOI:10.1007/s00330-006-157-x

  5. Remy-Jardin M, Delhaye D, Salem R, Teisseire A, Khalil C, Delannoy-Deken V, Duhamel A, Remy J (2006) Coronary imaging quality in routine ECG-gated multidetector CT examinations of the entire thorax: preliminary experience with a 64-slice CT system. Eur Radiol (submitted for publication)

  6. Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, Reyter PJ (2002) Reliable non-invasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 106:2051–2054

    Article  PubMed  Google Scholar 

  7. Hunold P, Vogt F, Schmermund A, Debatin JF, Kerkhoff G, Budde T, Erbel R, Ewen K, Barkhausen J (2003) Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT. Radiology 226:145–152

    Article  PubMed  Google Scholar 

  8. Mollet NR, Cademartiri F, Krestin G, McFadden EP, Arampatzis CA, Serruys PW, de Feyter PJ (2005) Improved diagnostic accuracy with 16-row multislice computed tomography coronary angiography. J Am Coll Cardiol 45:128–132

    Article  PubMed  Google Scholar 

  9. Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, Reiser MF (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086

    Article  PubMed  Google Scholar 

  10. Trabold T, Buchgeister M, Kurtner A et al (2003) Estimation of radiation exposure in 16-detecor row computed tomography of the heart with retrospective ECG-gating. Rofo 175:1051–1055

    PubMed  CAS  Google Scholar 

  11. Ropers D, Baum U, Pohle K, Anders K, Ulzheimer S, Ohnesorge B, Schlundt C, Bautz W, Daniel WG, Achenbach S (2003) Detection of coronary artery stenoses with thin-slice multidetector row spiral computed tomography and multiplanar reconstruction. Circulation 107:664–666

    Article  PubMed  Google Scholar 

  12. Wilberger JE, Mahnken AH, Schmitz-Rode T et al (2001) Individually adapted examination protocols for reduction of radiation exposure in chest CT. Invest Radiol 36:604–611

    Article  PubMed  Google Scholar 

  13. Tack D, De Maertelaer V, Gevenois PA (2003) Dose reduction in multidetector CT using attenuation-based on-line tube current modulation. AJR Am J Roentgenol 181:331–334

    PubMed  Google Scholar 

  14. Sigal-Cinqualbre AB, Hennequin R, Abada H, Chen X, Paul JF (2004) Low-kilovoltage multidetector-row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology 231:169–174

    Article  PubMed  Google Scholar 

  15. Das M, Horst G, Mahnken A, Mühlenbruch G, Stargardt A, Weis C, Flohr TG, Günther RW, Wildberger JE (2005) Individually adapted examination protocols for reduction of radiation exposure for 16-MDCT chest examinations. AJR Am J Roentgenol 184:1437–1443

    PubMed  Google Scholar 

  16. Van der Woude H, Zaagsma J, Postma DS, Winter TH, van Hulst M, Aalbers R (2005) Detrimental effects of beta-blockers in COPD. A concern for nonselective beta-blockers. Chest 127:818–824

    Article  PubMed  Google Scholar 

  17. Herzog C, Abolmaali N, Balzer JO, Baunach S, Ackerman H, Dogan S, Britten MB, Vogl TJ (2002) Heart-rate-adapted image reconstruction in multidetector-row cardiac CT: influence of physiological and technical prerequisite on image quality. Eur Radiol 12:2670–2678

    PubMed  Google Scholar 

  18. National Heart Lung and Blood Institute Obesity Education Initiative Expert Panel (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the Evidence Report. Rockville, Maryland: National Heart, Lung and Blood Institute

  19. EC99 (1999) European guidelines on quality criteria for computed tomography. Report EURO 16262 EN. Luxembourg:69–78

  20. Conover WJ, Iman RL (1981) Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat 35:124–129

    Article  Google Scholar 

  21. Heuschmid M, Kuettner A, Schroeder S, Trabold T, Feyer A, Seeman MD, Kuzo R, Claussen CD, Kopp AF (2005) ECG-gated 16-MDCT of the coronary arteries: assessment of image quality and accuracy in detecting stenoses. AJR Am J Roentgenol 184:1413–1419

    PubMed  Google Scholar 

  22. Cademartiri F, Mollet NR, Runza G, Stierstorfer K, Flohr T, Krestin GP (2004) 64-slice spiral computed coronary angiography: improvement of spatial and temporal resolution (abstract) Radiology (P):760

  23. Stark G, Cederblad A, Forssell-Aronsson E, Sjöström L, Alspen M (2002) A method to obtain the same levels of CT image noise for patients of various sizes, to minimize radiation dose. Br J Radiol 75:140–150

    PubMed  Google Scholar 

  24. Hundt W, Rust F, Stäbler A, Wolff H, Suess C, Reiser M (2005) Dose reduction in multislice computed tomography. J Comput Assist Tomogr 29:140–147

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille Cedex, France

    A. G. d’Agostino, M. Remy-Jardin, C. Khalil & J. Remy

  2. Department of Medical Statistics, University of Lille, Place de Verdun, 59037, Lille Cedex, France

    V. Delannoy-Deken & A. Duhamel

  3. Research & Development Department, CT Division, Siemens Medical, Forchheim, Germany

    T. Flohr

Authors
  1. A. G. d’Agostino
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  2. M. Remy-Jardin
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  3. C. Khalil
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  4. V. Delannoy-Deken
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  5. T. Flohr
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  6. A. Duhamel
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  7. J. Remy
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Correspondence to M. Remy-Jardin.

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d’Agostino, A.G., Remy-Jardin, M., Khalil, C. et al. Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients. Eur Radiol 16, 2137–2146 (2006). https://doi.org/10.1007/s00330-006-0218-1

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  • DOI: https://doi.org/10.1007/s00330-006-0218-1

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