La Radiologia Medica, 2015, Vol.120(12), p.1112(10)
Byline: Julian L. Wichmann (1,3), Xiaohan Hu (1), Alexander Engler (2), J. Matthias Kerl (1), Martin Beeres (1), Claudia Frellesen (1), Wolfgang Luboldt (1), Thomas J. Vogl (1), Ralf W. Bauer (1), Thomas Lehnert (1) Keywords: Coronary computed tomography angiography; Dual-source computed tomography angiography; Multidetector-computed tomography; High-pitch spiral acquisition; Radiation dose Abstract: Objectives To compare radiation exposure and image quality of second-generation 128-slice dual-source CT (DSCT) coronary angiography (cCTA) protocols. Materials and methods We retrospectively analyzed data from four groups with 25 patients, each examined by one of the following DSCT cCTA protocols: prospectively ECG-gated high-pitch (group 1) or sequential (group 2) acquisition, retrospectively ECG-gated acquisition in dual-energy (DECT, group 3) or dual-source (group 4) mode. CT dose index volume, dose length product, estimated radiation dose, contrast-to-noise- and signal-to-noise-ratios were compared. Subjective image quality was rated by two observers blinded to the protocols. Results High-pitch DSCT showed a mean estimated radiation dose of 1.27 [+ or -] 0.62 mSv, significantly (p 〈 0.01) lower than sequential (2.04 [+ or -] 0.94 mSv), dual-energy (3.97 [+ or -] 1.29 mSv) or dual-source (8.11 [+ or -] 4.95 mSv) acquisition. Image noise showed no statistical difference (p 〉 0.91), ranging from 15.2 [+ or -] 4.4 (group 2) up to 24.5 [+ or -] 22.0 (group 4). Each protocol showed diagnostic image quality in at least 98.1 % of evaluated coronary segments without significant differences (p 〉 0.05). Conclusions Prospectively ECG-gated DSCT protocols enable cCTA with significant dose reduction and consistently diagnostic image quality. In patients requiring retrospectively ECG-gated DSCT for functional analysis or due to arrhythmia, dual-energy mode should be preferred over dual-source mode as it significantly decreases estimated dose without compromising image quality. Author Affiliation: (1) Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (2) Department of Cranio-Maxillofacial and Plastic Facial Surgery, University Hospital Frankfurt, Frankfurt, Germany (3) Universitatsklinikum Frankfurt Am Main, Institut fur Diagnostische Und Interventionelle Radiologie, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany Article History: Registration Date: 28/04/2015 Received Date: 29/01/2015 Accepted Date: 28/04/2015 Online Date: 16/05/2015
Arrhythmia ; Angiography ; Electrocardiography ; Cat Scans
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