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Effect of a Standardized Radiation Dose Reduction Protocol on Diagnostic Accuracy of Coronary Computed Tomographic Angiography
- Source :
-
American Journal of Cardiology . Jul2010, Vol. 106 Issue 2, p287-292. 6p. - Publication Year :
- 2010
-
Abstract
- Although numerous strategies for radiation dose decrease in coronary computed tomographic angiography are effective, their combined impact on diagnostic performance is not known. We therefore assessed the effect of a standardized coronary computed tomographic angiographic protocol on diagnostic accuracy. We evaluated 80 consecutive patients from 3 sites with coronary computed tomographic angiography and quantitative coronary angiography. All sites initially used nonstandardized protocols; 2 sites then initiated a standardized protocol, and 1 site continued its nonstandardized protocol as a time-overlapping control. Two blinded readers interpreted coronary computed tomographic angiographic studies; a third obtained consensus. A blinded core laboratory performed quantitative coronary angiography. Each segment was graded as <50% or ≥50% diameter stenosis. Compared to those using nonstandardized protocols (n = 35), studies using standardized protocols (n = 45) had a trend to increased use of prospective gating (p = 0.09), lower voltage (p <0.01), decreased current (p <0.01), and shorter scan length (p <0.01). Median (interquartile range) radiation dose decreased from 5.7 mSv (4.0 to 10.8) to 2.0 mSv (1.3 to 3.4, p <0.001). There were no significant differences in sensitivity (100%, 20 of 20, vs 100%, 18 of 18, p = 1.0), specificity (93%, 14 of 15, vs 85%, 23 of 27, p = 0.61), or accuracy (97%, 34 of 35, vs 91%, 41 of 45, p = 0.27) by patient; sensitivity (83%, 33 of 40, vs 83%, 25 of 30, p = 0.93), specificity (92%, 86 of 93, vs 92%, 134 of 146, p = 0.85), or accuracy (89%, 119 of 133, vs 90%, 159 of 176, p = 0.80) by artery; or sensitivity (80%, 44 of 55, vs 72%, 26 of 36, p = 0.74), specificity (94%, 332 of 353, vs 94%, 499 of 531, p = 0.96), or accuracy (92%, 376 of 408, vs 93%, 525 of 567, p = 0.80) by segment. In conclusion, a standardized dose-decrease protocol for coronary computed tomographic angiography decreases radiation dose without affecting diagnostic performance. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 00029149
- Volume :
- 106
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- American Journal of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 51942124
- Full Text :
- https://doi.org/10.1016/j.amjcard.2010.02.038