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Tang X, Zhang Y, Wang T, Ma Y, Shi H, Yin R, Zou P, Cao J, Pan C. Image quality and diagnostic accuracy of different dosages of iodixanol in computed tomography angiography and perfusion of overweight patients with coronary artery stenosis: A feasibility study. Med Eng Phys 2022; 110:103818. [PMID: 35618562 DOI: 10.1016/j.medengphy.2022.103818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/11/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Iodixanol contrast media with different doses using computed tomography angiography (CTA) and perfusion (CTP) to diagnose coronary artery disease (CAD) in overweight patients lacks assessment. Our study compared iodixanol 320 mg I/ml and 270 mg I/ml on image quality and accuracy of CTA combined CTP (CTA-CTP) to diagnose CAD. METHODS Overweight patients with suspected of CAD were randomized into iodixanol 270 group (received iodixanol 270 mg I/ml) and iodixanol 320 group (received iodixanol 320 mg I/ml). Based on these characteristics data, receiver operating characteristic (ROC) curve and corresponding area under the curve (AUC) were plotted to assess the sensitivity and specificity of the two administrations. RESULTS The subjective definition score, signal to noise ratio, and CT value of aorta in iodixanol 320 group were higher than iodixanol 270 group. In iodixanol 270 group: the image exhibited a normal state of both vessels and myocardial perfusion; and the AUC, specificity, and sensitivity were 0.376, 66.67, and 80.46, respectively. In iodixanol 320 group: the image exhibited a diameter stenosis in right coronary artery and myocardial infarction of inferior wall and proximal inferior wall septum, as well as myocardial perfusion defects; and the AUC, specificity, and sensitivity in iodixanol 320 group were 0.824, 75.00, and 89.87, respectively. CONCLUSION Accuracy and image quality of iodixanol 320 mg I/ml in the diagnosis of CAD with CTA-CTP was higher than using iodixanol 270 mg I/ml.
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Affiliation(s)
- Xiaoqiang Tang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Yong Zhang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Tao Wang
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Yi Ma
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Haifeng Shi
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Ruohan Yin
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Ping Zou
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Jian Cao
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China
| | - Changjie Pan
- Department of Radiology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou 213164, China.
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Automated Identification of Coronary Arteries in Assisting Inexperienced Readers: Comparison between Two Commercial Vendors. Diagnostics (Basel) 2022; 12:diagnostics12081987. [PMID: 36010337 PMCID: PMC9406865 DOI: 10.3390/diagnostics12081987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: to assess the performance and speed of two commercially available advanced cardiac software packages in the automated identification of coronary vessels as an aiding tool for inexperienced readers. Methods: Hundred and sixty patients undergoing coronary CT angiography (CCTA) were prospectively enrolled from February until September 2021 and randomized in two groups, each one composed by 80 patients. Patients in group 1 were scanned on Revolution EVO CT Scanner (GE Healthcare), while patients in group 2 had the CCTA performed on Brilliance iCT (Philips Healthcare); each examination was evaluated on the respective vendor proprietary advanced cardiac software (software 1 and 2, respectively). Two inexperienced readers in cardiac imaging verified the software performance in the automated identification of the three major coronary vessels: (RCA, LCx, and LAD) and in the number of identified coronary segments. Time of analysis was also recorded. Results: software 1 correctly and automatically nominated 202/240 (84.2%) of the three main coronary vessels, while software 2 correctly identified 191/240 (79.6%) (p = 0.191). Software 1 achieved greater performances in recognizing the LCx (81.2% versus 67.5%; p = 0.048), while no differences have been reported in detecting the RCA (p = 0.679), and the LAD (p = 0.618). On a per-segment analysis, software 1 outperformed software 2, automatically detecting 942/1062 (88.7%) coronary segments, while software 2 detected 797/1078 (73.9%) (p < 0.001). Average reconstruction and detection time was of 13.8 s for software 1 and 21.9 s for software 2 (p < 0.001). Conclusions: automated cardiac software packages are a reliable and time-saving tool for inexperienced reader. Software 1 outperforms software 2 and might therefore better assist inexperienced CCTA readers in automated identification of the three main vessels and coronaries segments, with a consistent time saving of the reading session.
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Schick F, Ripa RS, Hansen TW, von Scholten BJ. Editorial: Advanced Cardiovascular Imaging in Diabetes. Front Endocrinol (Lausanne) 2022; 13:848975. [PMID: 35370983 PMCID: PMC8972965 DOI: 10.3389/fendo.2022.848975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fritz Schick
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, Tübingen University Hospital, Tübingen, Germany
| | - Rasmus Sejersten Ripa
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen, Denmark
| | - Tine Willum Hansen
- Complications Research, Steno Diabetes Center Copenhagen (SDCC), Gentofte, Denmark
| | - Bernt Johan von Scholten
- Global Chief Medical Office, Novo Nordisk, Copenhagen, Denmark
- *Correspondence: Bernt Johan von Scholten,
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Low kV Computed Tomography of Parenchymal Abdominal Organs-A Systematic Animal Study of Different Contrast Media Injection Protocols. Tomography 2021; 7:815-828. [PMID: 34941641 PMCID: PMC8705800 DOI: 10.3390/tomography7040069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives: To evaluate multiphase low kV computed tomography (CT) imaging of the abdomen with reduced contrast media (CM) dose using different injection protocols. Methods: Two injection protocols were evaluated for use with low kV (80 kV) multiphase abdominal imaging in comparison to the standard procedure acquired at 120 kV (500 mgI/kg; 5 mL/s). This evaluation was conducted in a highly standardized animal study (5 Goettingen minipigs). The low kV protocols consisted of (a) a single-flow (SF) injection with 40% reduced CM dose and injection rate (300 mgI/kg; 3 mL/s) and (b) a DualFlow (DF) injection protocol consisting of 60%/40% contrast to saline ratio administered at 5 mL/s. Dynamic CT was first performed within representative liver regions to determine optimal contrast phases, followed by evaluation of the three protocols in multiphase abdominal CT imaging. The evaluation criteria included contrast enhancement (CE) of abdominal organs and vasculature. Results: The 80 kV DF injection protocol showed similar CE of the abdominal parenchymatous organs and vessels to the 120 kV reference and the 80 kV SF protocol. Hepatic parenchyma showed comparable CT values for all contrast phases. In particular, in the portal venous parenchymal phase, the 80 kV DF protocol demonstrated higher hepatic parenchymal enhancement; however, results were statistically non-significant. Similarly, CE of the kidney, pancreas, and abdominal arterial/venous vessels showed no significant differences between injection protocols. Conclusions: Adapted SF and DF injection protocols with reduced IDR/iodine load offer the potential to calibrate optimal CM doses to the tube voltage in abdominal multiphase low kV CT imaging. The data suggest that the DF approach allows the use of predefined injection protocols and adaption of the contrast to saline ratio to an individualized kV setting and yields the potential for patient-individualized CM adaption.
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Cardiovascular Imaging in Obesity. Nutrients 2021; 13:nu13030744. [PMID: 33652678 PMCID: PMC7996902 DOI: 10.3390/nu13030744] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Obesity represents one of the most challenging public health problems of our century. It accounts for approximately 5% of deaths worldwide, mostly owing to cardiovascular disease and its associated complications. Cardiovascular noninvasive imaging may provide early accurate information about hypertrophy and ischemia/fibrosis in obese subjects. Echocardiography and nuclear cardiology have serious limitations in obese subjects owing to poor acoustic window and attenuation artifacts, respectively. Coronary computed tomography angiography can provide information about obstructive coronary disease; however, the use of radiation is a serious disadvantage. Finally, cardiac magnetic resonance (CMR) holds the promise of an "all in one" examination by combining evaluation of function, wall motion/thickness, stress rest/perfusion, replacement and diffuse fibrosis without radiation. Future studies are required to document the cost/benefit ratio of the CMR in the evaluation of cardiovascular risk in overweight/obese children and adolescents.
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Influence of contrast material density and kV setting on detectability of calcified plaques on coronary CT angiography. Eur J Radiol 2020; 132:109276. [DOI: 10.1016/j.ejrad.2020.109276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/13/2020] [Accepted: 09/06/2020] [Indexed: 11/16/2022]
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Evaluation of a Tube Voltage-Tailored Contrast Medium Injection Protocol for Coronary CT Angiography: Results From the Prospective VOLCANIC Study. AJR Am J Roentgenol 2020; 215:1049-1056. [PMID: 32960669 DOI: 10.2214/ajr.20.22777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE. The purpose of this study was to prospectively evaluate, using software support, the feasibility and the quantitative and qualitative image quality parameters of a tube voltage-tailored contrast medium (CM) application protocol for patient-specific injection during coronary CT angiography (CCTA). SUBJECTS AND METHODS. In the Voltage-Based Contrast Media Adaptation in Coronary Computed Tomography Angiography (VOLCANIC-CTA) study, a single-center trial, 120 patients referred for CCTA were prospectively assigned to a tube voltage-tailored CM injection protocol. Automated tube voltage levels were selected in 10-kV intervals and ranged from 70 to 130 kV, and the iodine delivery rate (IDR) was adapted to the tube voltage level using dedicated software. The administered CM volume (370 mg I/mL) ranged from 33 mL at 70 kV (IDR, 0.7 g I/s) to 65 mL at 130 kV (IDR, 1.7 g I/s). Attenuation was measured in the aorta and coronary arteries to calculate quantitative signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and 5-point scales were used to evaluate overall image quality. Radiation metrics were also assessed and compared among the protocols. RESULTS. The mean age of the study patients was 62.5 ± 11.9 (SD) years. Image quality was rated as diagnostic in all patients. Contrast attenuation peaked at 70 kV (p < 0.001), whereas SNR and CNR parameters showed no significant differences between tube voltage levels (p ≥ 0.085). Additionally, no significant differences in subjective image quality parameters were found among the different protocols (p ≥ 0.139). The lowest radiation dose values were observed in the group assigned to the 70-kV protocol, which had a median radiation effective dose of 2.0 mSv (p < 0.001). CONCLUSION. The proposed tube voltage-tailored injection protocol allows individualized scanning of patients undergoing CCTA and significantly reduces CM and radiation dose while maintaining a high diagnostic image quality.
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Comprehensive assessment of coronary computed tomography angiography by using Leaman and Leiden score in overweight and obese patients. Int J Cardiovasc Imaging 2020; 36:2377-2382. [DOI: 10.1007/s10554-020-01938-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/10/2020] [Indexed: 12/25/2022]
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9
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Hong JH, Park EA, Lee W, Ahn C, Kim JH. Incremental Image Noise Reduction in Coronary CT Angiography Using a Deep Learning-Based Technique with Iterative Reconstruction. Korean J Radiol 2020; 21:1165-1177. [PMID: 32729262 PMCID: PMC7458859 DOI: 10.3348/kjr.2020.0020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Objective To assess the feasibility of applying a deep learning-based denoising technique to coronary CT angiography (CCTA) along with iterative reconstruction for additional noise reduction. Materials and Methods We retrospectively enrolled 82 consecutive patients (male:female = 60:22; mean age, 67.0 ± 10.8 years) who had undergone both CCTA and invasive coronary artery angiography from March 2017 to June 2018. All included patients underwent CCTA with iterative reconstruction (ADMIRE level 3, Siemens Healthineers). We developed a deep learning based denoising technique (ClariCT.AI, ClariPI), which was based on a modified U-net type convolutional neural net model designed to predict the possible occurrence of low-dose noise in the originals. Denoised images were obtained by subtracting the predicted noise from the originals. Image noise, CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were objectively calculated. The edge rise distance (ERD) was measured as an indicator of image sharpness. Two blinded readers subjectively graded the image quality using a 5-point scale. Diagnostic performance of the CCTA was evaluated based on the presence or absence of significant stenosis (≥ 50% lumen reduction). Results Objective image qualities (original vs. denoised: image noise, 67.22 ± 25.74 vs. 52.64 ± 27.40; SNR [left main], 21.91 ± 6.38 vs. 30.35 ± 10.46; CNR [left main], 23.24 ± 6.52 vs. 31.93 ± 10.72; all p < 0.001) and subjective image quality (2.45 ± 0.62 vs. 3.65 ± 0.60, p < 0.001) improved significantly in the denoised images. The average ERDs of the denoised images were significantly smaller than those of originals (0.98 ± 0.08 vs. 0.09 ± 0.08, p < 0.001). With regard to diagnostic accuracy, no significant differences were observed among paired comparisons. Conclusion Application of the deep learning technique along with iterative reconstruction can enhance the noise reduction performance with a significant improvement in objective and subjective image qualities of CCTA images.
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Affiliation(s)
- Jung Hee Hong
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eun Ah Park
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
| | - Whal Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chulkyun Ahn
- Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Jong Hyo Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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Vingiani V, Abadia AF, Schoepf UJ, Fischer AM, Varga-Szemes A, Sahbaee P, Allmendinger T, Giovagnoli DA, Hudson HT, Marano R, Tinnefeld FC, Martin SS. Individualized coronary calcium scoring at any tube voltage using a kV-independent reconstruction algorithm. Eur Radiol 2020; 30:5834-5840. [PMID: 32468107 DOI: 10.1007/s00330-020-06951-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/11/2020] [Indexed: 01/17/2023]
Abstract
PURPOSE We prospectively investigate the feasibility of a patient specific automated tube voltage selection (ATVS)-based coronary artery calcium scoring (CACS) protocol, using a kV-independent reconstruction algorithm, to achieve significant dose reductions while maintaining the overall cardiac risk classification. METHODS Forty-three patients (mean age, 61.8 ± 9.0 years; 40% male) underwent a clinically indicated CACS scan at 120kVp, as well as an additional CACS acquisition using an individualized tube voltage between 70 and 130kVp based on the ATVS selection (CARE-kV). Datasets of the additional CACS scans were reconstructed using a kV-independent algorithm that allows for calcium scoring without changing the weighting threshold of 130HU, regardless of the tube voltage chosen for image acquisition. Agatston scores and radiation dose derived from the different ATVS-based CACS studies were compared to the standard acquisition at 120kVp. RESULTS Thirteen patients displayed a score of 0 and were correctly identified with the ATVS protocol. Agatston scores derived from the standard 120kVp (median, 33.4; IQR, 0-289.7) and the patient-tailored kV-independent protocol (median, 47.5; IQR, 0-287.5) showed no significant differences (p = 0.094). The intra-class correlation for Agatston scores derived from the two different protocols was excellent (ICC = 0.99). The mean dose-length-product was 29.8 ± 11.9 mGy × cm using the ATVS protocol and 31.7 ± 11.4 mGy × cm using the standard 120kVp protocol (p < 0.001). Additionally, 95% of patients were classified into the same risk category (0, 1-10, 11-100, 101-400, or > 400) using the patient-tailored protocol. CONCLUSIONS ATVS-based CACS, using a kV-independent algorithm, allows for high accuracy compared to the standard 120kVp scanning, while significantly reducing radiation dose parameters. KEY POINTS • ATVS allows for CT scanning with reduced radiation dose values. • KV-independent CACS is feasible at any tube voltage between 70 and 130 kVp. • ATVS applied to kV-independent CACS can significantly reduce the radiation dose.
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Affiliation(s)
- Vincenzo Vingiani
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA.,Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andres F Abadia
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - U Joseph Schoepf
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA.
| | - Andreas M Fischer
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - Akos Varga-Szemes
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - Pooyan Sahbaee
- Computed Tomography - Research & Development, Siemens Healthcare GmbH, Forchheim, Germany.,Siemens Medical Solutions USA, Malvern, PA, USA
| | - Thomas Allmendinger
- Computed Tomography - Research & Development, Siemens Healthcare GmbH, Forchheim, Germany
| | - Dante A Giovagnoli
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - H Todd Hudson
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - Riccardo Marano
- Department of Diagnostic Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fiona C Tinnefeld
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA
| | - Simon S Martin
- Department of Radiology and Radiological Sciences, Division of Cardiovascular Imaging, Medical University of South Carolina, 25 Courtenay Drive, Charleston, SC, USA.,Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
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Li W, Lyu L, Yang W, Zhang R, Wang G, Fang D, Song W, Yin J, Yang J, Li W, Chen L, Luo T. A Pilot Study of Third-Generation Dual-Source Computed Tomography for the Assessment of Global Dynamic Changes in Left Ventricular Structure and Function in a Porcine Model of Acute Myocardial Infarction. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019; 25:7989-7997. [PMID: 31649233 PMCID: PMC6825397 DOI: 10.12659/msm.919122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background First-generation and second-generation dual-source computed tomography (DSCT) are useful for analyzing left ventricle (LV) structure and function. This pilot study aimed to investigate the feasibility and role of third-generation DSCT for the evaluation of dynamic changes in LV structural and functional characteristics in a Diannan small-ear pig model of acute myocardial infarction (AMI). Material/Methods The model of AMI was established by balloon occlusion of the distal third of the left anterior descending (LAD) coronary artery in 14 Diannan small-eared pigs. Third-generation DSCT was performed to observe dynamic changes in LV structure and function before and after AMI was induced, with a follow-up period of 30 days. Results The mean structural measurements at baseline included interventricular septum thickness (8.50±0.90 mm), LV anterior wall thickness (8.40±1.30 mm), LV posterior wall thickness (7.80±1.20 mm), LV end-diastolic dimension (LVEDD) (45.00±4.90 mm), and LV end-systolic dimension (LVESD) (25.90±4.10 mm). The mean functional measurements at baseline included the LV end-diastolic volume (LVEDV) (74.62±13.54 ml), LV end-systolic volume (LVESV) (23.06±7.46 ml), LV ejection fraction (LVEF) (69.29±6.83%), LV mass (86.35±14.02 g), stroke volume (SV) (51.56±9.77 ml), and cardiac output (CO) (4.22±2.14 l/min). Trends of time-dependent changes were observed for LVESV, LVEF, SV, and CO, but not for LVEDV or LV mass. Conclusions Third-generation DSCT was validated as a tool for assessing dynamic changes in LV global function in a porcine model of AMI.
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Affiliation(s)
- Wenjia Li
- Chongqing Medical University, Chongqing, China (mainland).,Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Liang Lyu
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Weixin Yang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Rongshun Zhang
- Department of Radiology, Third People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Gang Wang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Dong Fang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Wei Song
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Junkun Yin
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Jiangmao Yang
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Wei Li
- Department of Radiology, First People's Hospital of Yunnan, Kunming, Yunnan, China (mainland)
| | - Liling Chen
- Kunming Medical University, Kunming, Yunnan, China (mainland)
| | - Tianyou Luo
- Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
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Lebedev S, Fournie E, Stierstorfer K, Kachelrieß M. Stack transition artifact removal (STAR) for cardiac CT. Med Phys 2019; 46:4777-4791. [PMID: 31444974 DOI: 10.1002/mp.13786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 06/12/2019] [Accepted: 07/03/2019] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION In cardiac computed tomography (CT), irregular motion may lead to unique artifacts for scanners with a longitudinal collimation that does not cover the entire heart. Given partial coverage, subvolumes, or stacks, may be reconstructed and used to assemble a final CT volume. Irregular motion, for example, due to cardiac arrhythmia or breathing, may cause mismatch between neighboring stacks and therefore discontinuities within the final CT volume. The aim of this work is the removal of the discontinuities that are hereafter referred to as stack transition artifacts. METHOD AND MATERIALS A stack transition artifact removal (STAR) is achieved using a symmetric deformable image registration. A symmetric Demons algorithm was implemented and applied to stacks to remove mismatch and therefore the stack transition artifacts. The registration can be controlled with one parameter that affects the smoothness of the deformation vector field (DVF). The latter is crucial for realistically transforming the stacks. Different smoothness settings as well as an entirely automatic parameter selection that considers the required deformation magnitude for each registration were tested with patient data. Thirteen datasets were evaluated. Simulations were performed on two additional datasets. RESULTS AND CONCLUSION STAR considerably improved image quality while computing realistic DVFs. Discontinuities, for example, appearing as breaks or cuts in coronary arteries or cardiac valves, were removed or considerably reduced. A constant smoothing parameter that ensured satisfactory results for all datasets was found. The automatic parameter selection was able to find a proper setting for each individual dataset. Consequently, no over regularization of the DVF occurred that would unnecessarily limit the registration accuracy for cases with small deformations. The automatic parameter selection yielded the best overall results and provided a registration method for cardiac data that does not require user input.
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Affiliation(s)
- Sergej Lebedev
- X-Ray Imaging and Computed Tomography, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Siemens Healthineers, 91301, Forchheim, Germany.,Department of Physics and Astronomy, University of Heidelberg, 69120, Heidelberg, Germany
| | | | | | - Marc Kachelrieß
- X-Ray Imaging and Computed Tomography, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Medical Faculty, University of Heidelberg, 69120, Heidelberg, Germany
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Effects of different CT angiography technology-based nursing methods on patients with coronary artery heart diseases. J Infect Public Health 2019; 13:2045-2048. [PMID: 31296480 DOI: 10.1016/j.jiph.2019.06.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/16/2019] [Accepted: 06/21/2019] [Indexed: 12/27/2022] Open
Abstract
To study the nursing effects of different CT angiography (CTA) technology-based nursing methods on patients with coronary artery heart diseases (CHD), CHD patients treated in Dongying People's Hospital were selected as the research objects and were divided into the control group and the observation group. Different coronary CTA nursing methods, i.e. the routine nursing and the psychological nursing, were performed to the control group and the observation group respectively. During the experiment, patients performed self-evaluations, which included the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Biological indicators of patients, including heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP), were measured before and after patients accepted different nursing methods. In addition, the quality of coronary CTA images was evaluated. The results showed that HR, DBP, SBP, SAS scores, and SDS scores of patients in the observation group were obviously lower than those in the control group, and the differences were statistically significant, besides, the image quality of the observation group was significantly greater than that of the control group, which was helpful for diagnosis and had statistical significances. Therefore, it is proved that the psychological nursing of CHD patients can effectively reduce the negative emotions of patients, such as anxiety and depression, which is conducive to CTA and can assist clinical diagnosis. The results provide a basis and ideas for more accurate research in the future.
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Uzu K, Otake H, Choi G, Toba T, Kim HJ, Roy A, Schaap M, Grady L, Kawata M, Shinke T, Taylor CA, Hirata KI. Lumen boundaries extracted from coronary computed tomography angiography on computed fractional flow reserve (FFRCT): validation with optical coherence tomography. EUROINTERVENTION 2019; 14:e1609-e1618. [DOI: 10.4244/eij-d-17-01132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Filtered back projection revisited in low-kilovolt computed tomography angiography: sharp filter kernel enhances visualization of the artery of Adamkiewicz. Neuroradiology 2018; 61:305-311. [DOI: 10.1007/s00234-018-2136-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 11/12/2018] [Indexed: 11/26/2022]
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16
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Zhang W, Ba Z, Wang Z, Lv H, Zhao J, Zhang Y, Zhang F, Song L. Diagnostic performance of low-radiation-dose and low-contrast-dose (double low-dose) coronary CT angiography for coronary artery stenosis. Medicine (Baltimore) 2018; 97:e11798. [PMID: 30142766 PMCID: PMC6113019 DOI: 10.1097/md.0000000000011798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The aim of the present study was to evaluate the diagnostic accuracy of low-radiation-dose and low-contrast-dose (double low-dose) coronary computed tomography angiography (CTA) for coronary artery stenosis in patients with suspected coronary artery disease (CAD).Totally 88 patients with suspected CAD were divided in the routine and double low-dose groups. Subjective image quality (IQ) was scored and diagnostic performance for detecting ≥50% stenosis was determined with the invasive coronary angiography. IQ and diagnostic performance were analyzed and compared between the 2 groups.There was no significant difference in the IQ of coronary artery between the routine and double low-dose groups, with good inter-observer agreement for the IQ. There were no significant differences in the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy on the per-patient, per-vessel, or per-segment level between the routine and double low-dose groups. The contrast medium injection volume in the double low-dose group was reduced by 37.1% compared with the routine-dose group. The effective dose in the double low dose was reduced by 44.5% compared with the routine-dose group.Double low-dose coronary CTA with IR can acquire satisfactory IQ and have high diagnostic sensitivity, specificity, and accuracy for the detection of coronary artery stenosis.
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Affiliation(s)
- Wei Zhang
- Department of Radiology, The Second Hospital of Shandong University, Shandong University, Jinan
| | - Zhaogui Ba
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong
| | - Zhenqiang Wang
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong
| | - Huaying Lv
- Department of Radiology, Laigang Hospital Affiliated to Taishan Medical University, Laiwu, Shandong
| | - Jun Zhao
- Department of Radiology, The Second Hospital of Shandong University, Shandong University, Jinan
| | - Yonghua Zhang
- Department of Radiology, People's Hospital of Yutian County, Yutian, Hebei, China
| | - Feixue Zhang
- Department of Radiology, The Second Hospital of Shandong University, Shandong University, Jinan
| | - Lei Song
- Department of Radiology, The Second Hospital of Shandong University, Shandong University, Jinan
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Contrast media injection protocol optimization for dual-energy coronary CT angiography: results from a circulation phantom. Eur Radiol 2018; 28:3473-3481. [PMID: 29488083 DOI: 10.1007/s00330-018-5308-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/20/2017] [Accepted: 01/03/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the minimum iodine delivery rate (IDR) required to achieve diagnostic coronary attenuation (300 HU) with dual-energy coronary CTA. METHODS Acquisitions were performed on a circulation phantom with a third- generation dual-source CT scanner. Contrast media was injected for a fixed time whilst IDRs varied from 1.0 to 0.3 gI/s in 0.1-gI/s intervals. Noise-optimized virtual monoenergetic imaging (VMI+) reconstructions from 40 to 90 keV in 5 keV increments were generated. Contrast-to-noise ratio (CNR) and coronary HU were measured for each injection. RESULTS VMI+ from 40-70 keV reached diagnostic attenuation with at least one IDR. The minimum IDR achieving a diagnostic attenuation ranged from 0.4 gI/s at 40 keV (312.8 HU) to 1.0 gI/s at 70 keV (334.1 HU). Attenuation values reached with IDR of 1.0 gI/s were significantly higher at each keV level (p<0.001). CNR showed a near perfect correlation with the IDR (ρ≥0.962; p<0.001), the IDR of 1.0 gI/s provided the highest CNR at each keV level, achieving the highest overall value at 40 keV (54.0±3.1). CONCLUSIONS IDRs from 0.4-1.0 gI/s associated with VMI+ from 40-70 keV provide diagnostic coronary attenuation with dual-energy coronary CTA. KEY POINTS • Iodine delivery rate (IDR) is a major determinant of contrast enhancement. • Low-keV noise-optimized monoenergetic images (VMI+) maximize iodine attenuation. • Low-keV VMI+ allows for lower IDRs while maintaining adequate coronary attenuation. • Lowest IDR to reach 300 HU was 0.4 gI/s, 40 keV VMI+.
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Arendt CT, Tischendorf P, Wichmann JL, Messerli M, Jörg L, Ehl N, Gohmann RF, Wildermuth S, Vogl TJ, Bauer RW. Using coronary CT angiography for guiding invasive coronary angiography: potential role to reduce intraprocedural radiation exposure. Eur Radiol 2018; 28:2756-2762. [PMID: 29417250 DOI: 10.1007/s00330-018-5317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/29/2017] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We investigated the potential reduction of patient exposure during invasive coronary angiography (ICA) if the procedure had only been directed to the vessel with at least one ≥ 50% stenosis as described in the CT report. METHODS Dose reports of 61 patients referred to ICA because of at least one ≥ 50% stenosis on coronary CT angiography (CCTA) were included. Dose-area product (DAP) was documented separately for left (LCA) and right coronary arteries (RCA) by summing up the single DAP for each angiographic projection. The study population was subdivided as follows: coronary intervention of LCA (group 1) or RCA (group 2) only, or of both vessels (group 3), or further bypass grafting (group 4), or no further intervention (group 5). RESULTS 57.4% of the study population could have benefitted from reduced exposure if catheterization had been directly guided to the vessel of interest as described on CCTA. Mean relative DAP reductions were as follows: group 1 (n = 18), 11.2%; group 2 (n = 2), 40.3%; group 3 (n = 10), 0%; group 4 (n = 3), 0%; group 5 (n = 28), 28.8%. CONCLUSIONS Directing ICA to the vessel with stenosis as described on CCTA would reduce intraprocedural patient exposure substantially, especially for patients with single-vessel stenosis. KEY POINTS • Patients with CAD can benefit from decreased radiation exposure during coronary angiography. • ICA should be directed solely to significant stenoses as described on CCTA. • Severely calcified plaques remain a limitation of CCTA leading to unnecessary ICA referrals.
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Affiliation(s)
- Christophe T Arendt
- Institute for Diagnostic and Interventional Radiology, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Patricia Tischendorf
- Institute for Diagnostic and Interventional Radiology, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Julian L Wichmann
- Institute for Diagnostic and Interventional Radiology, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Michael Messerli
- Clinic for Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.,Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zürich, Switzerland
| | - Lucas Jörg
- Clinic for Cardiology, Medical Department I, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Niklas Ehl
- Clinic for Cardiology, Medical Department I, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Robin F Gohmann
- Clinic for Diagnostic and Interventional Radiology, RWTH University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Simon Wildermuth
- Clinic for Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland
| | - Thomas J Vogl
- Institute for Diagnostic and Interventional Radiology, Clinic of the Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Ralf W Bauer
- RNS Gemeinschaftspraxis GbR, Private Radiology and Radiation Therapy Group, Alte Schmelze 20, 65201, Wiesbaden, Germany.
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Shimoyama S, Nishii T, Watanabe Y, Kono AK, Kagawa K, Takahashi S, Sugimura K. Advantages of 70-kV CT Angiography for the Visualization of the Adamkiewicz Artery: Comparison with 120-kV Imaging. AJNR Am J Neuroradiol 2017; 38:2399-2405. [PMID: 28912277 DOI: 10.3174/ajnr.a5372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 07/07/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Preprocedural identification of the Adamkiewicz artery is crucial in patients with aortic diseases. This study aimed to compare 70-kV CTA with conventional 120-kV CTA for the identification of the Adamkiewicz artery, examining differences in radiation dose and image quality. MATERIALS AND METHODS We retrospectively analyzed 2 equal groups of 60 patients who had undergone 70-kV or 120-kV CTA to detect the Adamkiewicz artery before aortic repair. Size-specific dose estimate, the CT number of the aorta, and the contrast-to-noise ratio of the anterior spinal artery to the spinal cord were recorded. Furthermore, detectability of the Adamkiewicz artery was evaluated by using a 4-point continuity score (3, definite to 0, undetectable). RESULTS There was significantly lower radiation exposure with 70-kV CTA than 120-kV CTA (median size-specific dose estimate, 23.1 versus 61.3 mGy, respectively; P < .001). CT number and contrast-to-noise ratio were both significantly higher in the 70-kV CTA group than the 120-kV group (999.1 HU compared with 508.7 HU, and 5.6 compared with 3.4, respectively; P < .001 for both). Detectability of the Adamkiewicz artery was not impaired in the 70-kV CTA group (90.0% versus 83.3% in the 120-kV group, P = .28). Moreover, the Adamkiewicz artery was detected with greater confidence with 70-kV CTA, reflected by a significantly superior continuity score (median, 3) compared with 120-kV CTA (median, 2; P = .001). CONCLUSIONS Seventy-kilovolt CTA has substantial advantages for the identification of the Adamkiewicz artery before aortic repair, with a significantly lower radiation exposure and superior image quality than 120-kV CTA.
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Affiliation(s)
- S Shimoyama
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - T Nishii
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Y Watanabe
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
- Department of Radiology (Y.W., A.K.K.), National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - A K Kono
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
- Department of Radiology (Y.W., A.K.K.), National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Kagawa
- Division of Radiology (K.K.), Center for Radiology and Radiation Oncology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - S Takahashi
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - K Sugimura
- From the Department of Radiology (S.S., T.N., Y.W., A.K.K., S.T., K.S.), Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Diagnostic accuracy of low and high tube voltage coronary CT angiography using an X-ray tube potential-tailored contrast medium injection protocol. Eur Radiol 2017; 28:2134-2142. [PMID: 29181587 DOI: 10.1007/s00330-017-5150-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/07/2017] [Accepted: 10/18/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To compare the diagnostic accuracy between low-kilovolt peak (kVp) (≤ 100) and high-kVp (> 100) third-generation dual-source coronary CT angiography (CCTA) using a kVp-tailored contrast media injection protocol. METHODS One hundred twenty patients (mean age = 62.6 years, BMI = 29.0 kg/m2) who underwent catheter angiography and CCTA with automated kVp selection were separated into two cohorts (each n = 60, mean kVp = 84 and 117). Contrast media dose was tailored to the kVp level: 70 = 40 ml, 80 = 50 ml, 90 = 60 ml, 100 = 70 ml, 110 = 80 ml, and 120 = 90 ml. Contrast-to-noise ratio (CNR) was measured. Two observers evaluated image quality and the presence of significant coronary stenosis (> 50% luminal narrowing). RESULTS Diagnostic accuracy (sensitivity/specificity) with ≤ 100 vs. > 100 kVp CCTA was comparable: per patient = 93.9/92.6% vs. 90.9/92.6%, per vessel = 91.5/97.8% vs. 94.0/96.8%, and per segment = 90.0/96.7% vs. 90.7/95.2% (all P > 0.64). CNR was similar (P > 0.18) in the low-kVp vs. high-kVp group (12.0 vs. 11.1), as ws subjective image quality (P = 0.38). Contrast media requirements were reduced by 38.1% in the low- vs. high-kVp cohort (53.6 vs. 86.6 ml, P < 0.001) and radiation dose by 59.6% (4.3 vs. 10.6 mSv, P < 0.001). CONCLUSIONS Automated tube voltage selection with a tailored contrast media injection protocol allows CCTA to be performed at ≤ 100 kVp with substantial dose reductions and equivalent diagnostic accuracy for coronary stenosis detection compared to acquisitions at > 100 kVp. KEY POINTS • Low-kVp coronary CT angiography (CCTA) enables reduced contrast and radiation dose. • Diagnostic accuracy is comparable between ≤ 100 and > 100 kVp CCTA. • Image quality is similar for low- and high-kVp CCTA. • Low-kVp image acquisition is facilitated by automated tube voltage selection. • Tailoring contrast injection protocols to the automatically selected kVp-level is feasible.
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Andreini D, Pontone G, Mushtaq S, Mancini ME, Conte E, Guglielmo M, Volpato V, Annoni A, Baggiano A, Formenti A, Ditali V, Perchinunno M, Fiorentini C, Bartorelli AL, Pepi M. Image quality and radiation dose of coronary CT angiography performed with whole-heart coverage CT scanner with intra-cycle motion correction algorithm in patients with atrial fibrillation. Eur Radiol 2017; 28:1383-1392. [DOI: 10.1007/s00330-017-5131-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 10/05/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
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