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Image quality, radiation dose, and diagnostic accuracy of prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp in a clinical setting: comparison with invasive coronary angiography.
- Source :
-
European radiology [Eur Radiol] 2016 Mar; Vol. 26 (3), pp. 797-806. Date of Electronic Publication: 2015 Sep 17. - Publication Year :
- 2016
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Abstract
- Purpose: To investigate image quality, radiation dose, and diagnostic performance of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp compared to invasive coronary angiography (ICA) as reference standard.<br />Materials and Methods: Forty-three patients underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp using 30 cc (11 g iodine) contrast medium and ICA. Subjective and objective image quality was evaluated for each CCTA study. CCTA performance for diagnosing ≥50% stenosis was assessed. Results were stratified according to heart rate (HR), body mass index (BMI), Agatston score, and image quality.<br />Results: At CCTA, 94.3% (500/530) of coronary segments were of diagnostic quality. Using ICA as reference standard, sensitivity and accuracy were 100% and 93.0% on a per-patient basis. Per-vessel and per-segment performances were 92.2% and 89.5%; 79.5% and 88.3%, respectively. No differences were found in diagnostic accuracy between different HR, BMI, and calcification subgroups (all P > 0.05) on a per-patient basis. However, low image quality reduced diagnostic accuracy on a per-patient, per-vessel and per-segment basis (all P < 0.05). The mean effective radiation dose was 0.2 ± 0.0 mSv.<br />Conclusion: Our presented protocol results in an effective radiation dose of 0.2 mSv and high diagnostic accuracy for stenosis detection in a selected, non-obese population.<br />Key Points: Prospectively ECG-triggered high-pitch CCTA at 70 kVp is feasible. This protocol has a high diagnostic accuracy for stenosis detection. The mean effective radiation dose was 0.2 ± 0.0 mSv. Only 30 cc of contrast material is used in this protocol. Low image quality reduced diagnostic accuracy of CCTA.
- Subjects :
- Adult
Aged
Aged, 80 and over
Body Mass Index
Contrast Media
Coronary Angiography standards
Electrocardiography methods
Female
Heart radiation effects
Heart Rate radiation effects
Humans
Male
Middle Aged
Prospective Studies
Radiation Dosage
Reference Standards
Sensitivity and Specificity
Tomography, X-Ray Computed standards
Coronary Angiography methods
Coronary Stenosis diagnostic imaging
Tomography, X-Ray Computed methods
Vascular Calcification diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 26382844
- Full Text :
- https://doi.org/10.1007/s00330-015-3868-z