Clinical feasibility of catheter-directed selective intracoronary computed tomography angiography using an extremely low dose of iodine in patients with coronary artery disease
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This study aimed to evaluate the clinical feasibility of catheter-directed selective computed tomography angiography (S-CTA) in patients with coronary artery disease (CAD).
We prospectively enrolled 65 patients diagnosed with CAD who underwent conventional computed tomography angiography (C-CTA). C-CTA was performed with 60–90 mL of contrast medium (370 mg iodine/mL), whereas S-CTA was performed with 15 mL of contrast medium and 17.19 mg iodine/mL. Luminal enhancement range, homogeneity of luminal enhancement, image quality, plaque volume (PV), and percent aggregate plaque volume (%APV) were measured. Paired Student’s t test, Wilcoxon rank-sum test, and Pearson’s correlation coefficient were used to compare two methods.
Luminal enhancement was significantly higher on S-CTA than on C-CTA (324.4 ± 8.0 Hounsfield unit (HU) vs. 312.0 ± 8.0 HU, p < 0.0001 in the per-vessel analysis). Transluminal attenuation gradient showed a significantly slower reduction pattern on S-CTA than on C-CTA (-0.65 HU/10 mm vs. -0.89 HU/10 mm, p < 0.0001 in the per-vessel analysis). Image noise was significantly lower on S-CTA than on C-CTA (39.6 ± 10.0 HU vs. 43.9 ± 9.4 HU, p < 0.0001). There was excellent correlation between S-CTA and C-CTA with respect to PV and %APV (r = 0.99, r = 0.98, respectively).
S-CTA might be useful in facilitating atherosclerotic plaque analysis and providing guidance for complex lesions such as chronic total occlusion, particularly in cases in which on-site procedure planning is required.
• Selective computed tomography angiography (S-CTA) can serve as an intraprocedural computed tomography angiography protocol.
• S-CTA was performed with low dose of iodine compared with conventional computed tomography angiography.
• S-CTA enables on-site atherosclerotic plaque analysis.
KeywordsCoronary arteries Coronary angiography Contrast media Cardiac imaging technique Atherosclerotic plaque
Aggregated plaque volume
Coronary artery disease
Conventional computed tomography angiography
Computational fluid dynamics
Computed tomography angiography
Chronic total occlusion
Fractional flow reserve
Invasive coronary angiography
Region of interest
Selective computed tomography angiography
Transluminal attenuation gradient
This research was supported by Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (MSIP) (No. 2012027176).
Compliance with ethical standards
The scientific guarantor of this publication is Dr. Chang Hyuk-Jae.
Conflict of interest
The authors declare that they have no conflict of interest.
Statistics and biometry
Dr. Sung Ji-Min kindly provided statistical advice for this manuscript.
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• Performed at one institution
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