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Choice strategy of different dose-saving protocols in 64-slice MDCT coronary angiography

Strategia di applicazione dei differenti protocolli di risparmio di dose in angiografia coronarica mediante TCMS a 64 strati

  • Cardiac Radiology/Cardioradiologia
  • Published:
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Abstract

Purpose

Multidetector-row computed tomography coronary angiography (MDCT-CA) produces high-level radiation dose because of submillimetre slice thickness and short scan time. As a result, manufacturers have produced different dose-saving protocols that may, however, reduce image quality and thus diagnostic accuracy. The aim of our study was to assess the diagnostic quality of MDCT-CA using different dose-saving protocols.

Materials and methods

Between April and August 2008, we examined 65 patients with 64-slice MDCT-CA: 6/65 using the step-and-shoot dose-saving protocol, 45/65 the cardiac dose right protocol and 14/65 using a standard protocol. Image quality was evaluated on a per-patient and per-segment basis, and the effective dose of each protocol was recorded.

Results

In the per-patient analysis, image quality was excellent in 100% of the step-and-shoot protocols, in 91.1% of the cardiac dose right protocols and in 85.8% of the standard protocols. Effective dose to the patient considering the whole study (i.e. scout, calcium score, triggering and MDCT-CA) was 20.49 mSv in the standard protocol, 14.8 mSv in the cardiac dose right protocol and 6.63 mSv in the step-and-shoot protocol.

Conclusions

The radiologist should apply the appropriate protocol in relation to the clinical indications, type of patient and information required in order to spare as much dose as possible while maintaining high image quality.

Riassunto

Introduzione

L’angiografia coronarica con tomografia computerizzata multistrato (AC-TCMS) comporta una dose elevata a causa di spessori submillimetrici e ridotti tempi di acquisizione; le case costruttrici quindi hanno prodotto protocolli di risparmio di dose che però possono ridurre la qualità delle immagini e l’accuratezza diagnostica. Lo scopo di questo lavoro è valutare la qualità diagnostica nello studio delle arterie coronarie con i differenti protocolli di risparmio di dose.

Materiali e metodi

Tra aprile e agosto 2008, 65 pazienti sono stati sottoposti ad AC-TCMS a 64 detettori; 6/65 mediante protocollo step and shoot, 45/65 con protocollo cardiac dose right, 14/65 con protocollo standard. È stata valutata la qualità delle immagini con analisi per paziente e per segmento ed è stata calcolata la dose effettiva per ciascun protocollo di acquisizione.

Risultati

Nelle analisi per paziente la qualità delle immagini è risultata ottimale nel 100% dei casi per il protocollo step and shoot, nel 91,1% dei casi per il protocollo cardiac dose right e nell’85,8% dei casi per il protocollo standard. La dose effettiva al paziente dell’intero esame (calcium score e AC-TCMS) è risultata pari a 20,49 mSv nel protocollo standard, 14,8 mSv nel protocollo cardiac dose right e 6,63 mSv per il protocollo step and shoot.

Conclusioni

Il radiologo deve utilizzare il protocollo di scansione più adatto a seconda dell’indicazione clinica, del paziente e del tipo di informazioni necessarie per l’iter diagnostico.

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Authors and Affiliations

  1. Istituto di Radiologia, Policlinico “G.B. Rossi” Università di Verona, P.le L.A.Scuro 10, 37134, Verona, Italy

    R. Malagò, M. D’Onofrio, I. Baglio, S. Brunelli & R. Pozzi Mucelli

  2. Unità Operativa di Cardiologia, Policlinico “G.B. Rossi” Università di Verona, P.le L.A.Scuro 10, 37134, Verona, Italy

    D. Tavella, F. Beltrame & P. Benussi

Authors
  1. R. Malagò
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  2. M. D’Onofrio
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  3. I. Baglio
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  4. S. Brunelli
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  6. F. Beltrame
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  7. P. Benussi
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  8. R. Pozzi Mucelli
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Correspondence to R. Malagò.

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Malagò, R., D’Onofrio, M., Baglio, I. et al. Choice strategy of different dose-saving protocols in 64-slice MDCT coronary angiography. Radiol med 114, 1196–1213 (2009). https://doi.org/10.1007/s11547-009-0432-4

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  • DOI: https://doi.org/10.1007/s11547-009-0432-4

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