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Prospectively gated axial CT coronary angiography: comparison of image quality and effective radiation dose between 64- and 256-slice CT

European Radiology volume 20, pages 1124–1131 (2010)Cite this article

Abstract

Purpose

To compare image quality and effective radiation dose for prospectively gated axial CT coronary angiography on 64- and 256-slice CT.

Methods

The patient cohort consisted of 80 consecutive patients undergoing imaging with 256-slice CT and 80 patients with 64-slice CT. The two patient groups were demographically matched according to age, gender, body mass index and heart rate. For both groups, two observers independently assessed image quality for all coronary segments on a five-point ordinal scale. The two groups were compared with regard to image quality and effective radiation dose. Image quality scores less than 3 were considered non-diagnostic.

Results

Mean effective radiation dose did not significantly differ between the two groups (3.4 ± 0.8 mSv in both groups; p > 0.1). Vessel-based image quality was significantly better in patients undergoing 256-slice CT compared with those undergoing 64-slice CT (p < 0.001). The proportion of assessable coronary segments significantly increased from 95.6% in the 64-slice group to 98.9% in the 256-slice group (p < 0.05).

Conclusion

Prospectively gated axial CT coronary angiography performed on 256-slice CT provides significantly improved and more stable image quality at an equivalent effective radiation dose compared with 64-slice CT.

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References

  1. Earls JP, Berman EL, Urban BA et al (2008 ) Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology 246:742–753

    Article  PubMed  Google Scholar 

  2. Scheffel H, Alkadhi H, Leschka S et al (2008) Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart 94:1132–1137

    Article  CAS  PubMed  Google Scholar 

  3. Shuman WP, Branch KR, May JM et al (2008) Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology 248:431–437

    Article  PubMed  Google Scholar 

  4. Klass O, Jeltsch M, Feuerlein S et al (2008) Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique. Eur Radiol. doi:10.1007/s00330-008-1222-4

    Google Scholar 

  5. Husmann L, Valenta I, Gaemperli O et al (2008) Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J 29:191–197

    Article  PubMed  Google Scholar 

  6. Weigold WG, Olszewski ME, Walker MJ (2009) Low-dose prospectively gated 256-slice coronary computed tomographic angiography. Int J Cardiovasc Imaging. doi:10.1007/s10554-009-9439-0

    Google Scholar 

  7. Rybicki FJ, Otero HJ, Steigner ML et al (2008) Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging. doi:10.1007/s10554-008-9308-2

    Google Scholar 

  8. Mori S, Nishizawa K, Kondo C, Ohno M, Akahane K, Endo M (2007) Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner. Eur J Radiol. doi:10.1016/j.ejrad.2007.05.001

    Google Scholar 

  9. Rybicki FJ, Otero HJ, Steigner ML et al (2008) Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging 24:535–546

    Article  PubMed  Google Scholar 

  10. Walker MJ, Olszewski ME, Desai MY, Halliburton SS, Flamm SD (2009) New radiation dose saving technologies for 256-slice cardiac computed tomography angiography. Int J Cardiovasc Imaging. doi:10.1007/s10554-009-9444-3

    Google Scholar 

  11. Austen WG, Edwards JE, Frye RL et al (1975 ) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American heart association. Circulation 51(Suppl):5–40

    CAS  PubMed  Google Scholar 

  12. Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428

    Article  CAS  PubMed  Google Scholar 

  13. McCollough C CD, Edyvean S et al (2008) The measurement, reporting, and management of radiation dose in CT. American Association of Physicists in Medicine report no 96. Available via http://www.aapm.org/pubs/reports/rpt_96.pdf. Accessed 21 Sept 2009

  14. Shrimpton P (2004) Assessment of patient dose in CT. NRPB-PE/1/2004 National Radiological Protection Board. Available via http://www.msct.eu/CT_Quality_Criteria.htm#Download%20the%202004%20CT%20Quality%20Criteria. Accessed 21 Sept 2009

  15. Stolzmann P, Leschka S, Scheffel H et al (2008) Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose. Radiology 249:71–80

    Article  PubMed  Google Scholar 

  16. Leschka S, Wildermuth S, Boehm T et al (2006) Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 241:378–385

    Article  PubMed  Google Scholar 

  17. Soliman OI, Kirschbaum SW, van Dalen BM et al (2008) Accuracy and reproducibility of quantitation of left ventricular function by real-time three-dimensional echocardiography versus cardiac magnetic resonance. Am J Cardiol 102:778–783

    Article  PubMed  Google Scholar 

  18. Matt D, Scheffel H, Leschka S et al (2007) Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability. AJR Am J Roentgenol 189:567–573

    Article  PubMed  Google Scholar 

  19. Katritsis D, Efstathopoulos E, Betsou S et al (2000) Radiation exposure of patients and coronary arteries in the stent era: A prospective study. Catheter Cardiovasc Interv 51:259–264

    Article  CAS  PubMed  Google Scholar 

  20. Kocinaj D, Cioppa A, Ambrosini G et al (2006 ) Radiation dose exposure during cardiac and peripheral arteries catheterisation. Int J Cardiol 113:283–284

    Article  CAS  PubMed  Google Scholar 

  21. Miller SW, Castronovo FP Jr (1985 ) Radiation exposure and protection in cardiac catheterization laboratories. Am J Cardiol 55:171–176

    Article  CAS  PubMed  Google Scholar 

  22. Watson LE, Riggs MW, Bourland PD (1997 ) Radiation exposure during cardiology fellowship training. Health Phys 73:690–693

    CAS  PubMed  Article  Google Scholar 

  23. Huda W, Vance A (2007) Patient radiation doses from adult and pediatric CT. AJR Am J Roentgenol 188:540–546

    Article  PubMed  Google Scholar 

  24. Poll LW, Cohnen M, Brachten S, Ewen K, Modder U (2002) Dose reduction in multi-slice CT of the heart by use of ECG-controlled tube current modulation ("ECG pulsing"): phantom measurements. Rofo 174:1500–1505

    CAS  PubMed  Google Scholar 

  25. Hausleiter J, Meyer T, Hermann F et al (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301:500–507

    Article  CAS  PubMed  Google Scholar 

  26. Jakobs TF, Becker CR, Ohnesorge B et al (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 

  27. Johnson TR, Nikolaou K, Wintersperger BJ et al (2006) Dual-source CT cardiac imaging: initial experience. Eur Radiol 16:1409–1415

    Article  PubMed  Google Scholar 

  28. Ertel D, Lell MM, Harig F, Flohr T, Schmidt B, Kalender WA (2009) Cardiac spiral dual-source CT with high pitch: a feasibility study. Eur Radiol. doi:10.1007/s00330-009-1503-6

    Google Scholar 

  29. Mori S, Nishizawa K, Kondo C, Ohno M, Akahane K, Endo M (2008) Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner. Eur J Radiol 65:442–448

    Article  PubMed  Google Scholar 

  30. Jung B, Mahnken AH, Stargardt A et al (2003) Individually weight-adapted examination protocol in retrospectively ECG-gated MSCT of the heart. Eur Radiol 13:2560–2566

    Article  CAS  PubMed  Google Scholar 

  31. Hsieh J, Londt J, Vass M, Li J, Tang X, Okerlund D (2006) Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. Med Phys 33:4236–4248

    Article  PubMed  Google Scholar 

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Acknowledgements

This study has been exclusively financed from research funds provided by the state of Baden-Württemberg, Germany.

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Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Steinhövelstr. 9, 89075, Ulm, Germany

    Oliver Klass, Anne Siebach, Tina Stuber, Sebastian Feuerlein, Markus Juchems & Martin H. K. Hoffmann

  2. Philips Healthcare, CT Clinical Science, Cleveland, OH, USA

    Matthew Walker

Authors
  1. Oliver Klass
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  2. Matthew Walker
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  3. Anne Siebach
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  4. Tina Stuber
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  5. Sebastian Feuerlein
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  6. Markus Juchems
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  7. Martin H. K. Hoffmann
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Correspondence to Oliver Klass.

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Klass, O., Walker, M., Siebach, A. et al. Prospectively gated axial CT coronary angiography: comparison of image quality and effective radiation dose between 64- and 256-slice CT. Eur Radiol 20, 1124–1131 (2010). https://doi.org/10.1007/s00330-009-1652-7

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  • DOI: https://doi.org/10.1007/s00330-009-1652-7

Keywords

  • CT coronary angiography (CTCA)
  • Radiation exposure
  • Prospectively gated axial imaging technique
  • Step and shoot