Document Detail

Impact of heart rate and rhythm on radiation exposure in prospectively ECG triggered computed tomography.
MedLine Citation:
PMID:  22019599     Owner:  NLM     Status:  Publisher    
PURPOSE: To evaluate the influence of different heart rates and arrhythmias on scanner performance, image acquisition and applied radiation exposure in prospectively ECG triggered computed tomography (pCT). MATERIALS AND METHODS: An ECG simulator (EKG Phantom 320, Müller & Sebastiani Elektronik GmbH, Munich, Germany) was used to generate different heart rhythms and arrhythmias: sinus rhythm (SR) at 45, 60, 75, 90 and 120/min, supraventricular arrhythmias (e.g. sinus arrhythmia, atrial fibrillation) and ventricular arrhythmias (e.g. ventricular extrasystoles), pacemaker-ECGs, ST-changes and technical artifacts. The analysis of the image acquisition process was performed on a 64-row multidetector CT (Brilliance, Philips Medical Systems, Cleveland, USA). A prospectively triggered scan protocol as used for routine was applied (120kV; 150mAs; 0.4s rotation and exposure time per scan; image acquisition predominantly in end-diastole at 75% R-R-interval, in arrythmias with a mean heart rate above 80/min in systole at 45% of the R-R-interval; FOV 25cm). The mean dose length product (DLP) and its percentage increase from baseline (SR at 60/min) were determined. RESULT: Radiation exposure can increase significantly when the heart rhythm deviates from sinus rhythm. ECG-changes leading to a significant DLP increase (p<0.05) were bifocal pacemaker (61%), pacemaker dysfunction (22%), SVES (20%), ventricular salvo (20%), and atrial fibrillation (14%). Significantly (p<0.05) prolonged scan time (>8s) could be observed in bifocal pacemaker (12.8s), pacemaker dysfunction (10.7s), atrial fibrillation (10.3s) and sinus arrhythmia (9.3s). CONCLUSION: In prospectively ECG triggered CT, heart rate and rhythm can provoke different types of scanner performance, which can significantly alter radiation exposure and scan time. These results might have an important implication for indication, informed consent and contrast agent injection protocols.
Christian Luecke; Claudia Andres; Borek Foldyna; Hans Dieter Nagel; Janine Hoffmann; Matthias Grothoff; Stefan Nitzsche; Matthias Gutberlet; Lukas Lehmkuhl
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-21
Journal Detail:
Title:  European journal of radiology     Volume:  -     ISSN:  1872-7727     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.
University of Leipzig - Heart Center, Department of Diagnostic and Interventional Radiology, Strümpellstrasse 39, D-04289, Leipzig, Germany.
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