Document Detail


Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose.
MedLine Citation:
PMID:  18574140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To show that prospective electrocardiographically (ECG)-triggered coronary computed tomographic (CT) angiography (hereafter, prospective CT angiography) is at least as effective as retrospective ECG-gated coronary CT angiography (hereafter, retrospective CT angiography). MATERIALS AND METHODS: Institutional review committee approval and informed consent were obtained. Sixty patients with heart rates of less than 75 beats per minute who were referred for coronary CT angiography were enrolled. Both prospective and retrospective CT angiography were performed with a 64-detector scanner. Data acquisition times were recorded. Two independent cardiac radiologists evaluated subjective image quality (1, excellent; 4, poor) and severity of stenosis (0% occlusion, 1%-49% occlusion, 50%-75% occlusion, and >75% occlusion) with the 17-segment American Heart Association classification model. Discrepancies were settled by consensus. Effective radiation doses of prospective and retrospective CT angiography were calculated with volume CT dose index. Data regarding acquisition time and radiation exposure for prospective and retrospective CT angiography were compared. The Student t test was performed, and kappa statistics were calculated. RESULTS: Mean data acquisition time of prospective CT angiography was shorter than that of retrospective CT angiography (5.6 seconds +/- 1.1 [standard deviation] vs 6.7 seconds +/- 1.1, respectively; P < .01). Consensus-determined image quality in coronary artery branches was similar between prospective CT angiography and retrospective CT angiography (1.15 vs 1.13, respectively; P = .992). Excellent agreement between prospective CT angiography and retrospective CT angiography was observed in the detection of significant (>or=50% occlusion) coronary artery stenoses per segment (kappa = 0.882) and in the grading of stenoses per patient (kappa = 0.829). Calculated effective dose with prospective CT angiography was 79% lower than that with retrospective CT angiography (4.1 mSv +/- 1.8 vs 20.0 mSv +/- 3.5, respectively; P < .001). CONCLUSION: Prospective CT angiography can reduce radiation dose below that of retrospective CT angiography with dose modulation, while maintaining image quality and the ability to assess luminal obstructions in patients with heart rates of less than 75 beats per minute.
Authors:
Nobuhiko Hirai; Jun Horiguchi; Chikako Fujioka; Masao Kiguchi; Hideya Yamamoto; Noriaki Matsuura; Toshiro Kitagawa; Hiroki Teragawa; Nobuoki Kohno; Katsuhide Ito
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-06-23
Journal Detail:
Title:  Radiology     Volume:  248     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-21     Completed Date:  2008-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  424-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Contrast Media
Coronary Angiography / methods*
Coronary Stenosis / radiography*
Electrocardiography
Female
Humans
Iopamidol / diagnostic use
Male
Middle Aged
Prospective Studies
Radiation Dosage
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Statistics, Nonparametric
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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