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Erschienen in: European Radiology 4/2018

21.11.2017 | Cardiac

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

verfasst von: Daniele Andreini, Gianluca Pontone, Saima Mushtaq, Maria Elisabetta Mancini, Edoardo Conte, Marco Guglielmo, Valentina Volpato, Andrea Annoni, Andrea Baggiano, Alberto Formenti, Valentina Ditali, Marco Perchinunno, Cesare Fiorentini, Antonio L. Bartorelli, Mauro Pepi

Erschienen in: European Radiology | Ausgabe 4/2018

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Abstract

Objectives

To evaluate image quality, coronary evaluability and radiation exposure of coronary CT angiography (CCTA) performed with whole-heart coverage cardiac-CT in patients with atrial fibrillation (AF).

Materials and methods

We prospectively enrolled 164 patients with AF who underwent a clinically indicated CCTA with a 16-cm z-axis coverage scanner. In all patients CCTA was performed using prospective ECG-triggering with targeted RR interval. We evaluated image quality, coronary evaluability and effective dose (ED). Patients were divided in two subgroups based on heart rate (HR) during imaging. Group 1: 64 patients with low HR (<75 bpm), group 2: 100 patients with high HR (≥75 bpm). Written informed consent was obtained from all patients and the institutional ethics committee approved the study protocol.

Results

In a segment-based analysis, coronary evaluability was 98.4 % (2,577/2,620 segments) in the whole population, without significant differences between groups (1,013/1,024 (98.9 %) and 1,565/1,596 (98.1 %), for groups 1 and 2, respectively, p=0.15). Mean ED was similar in both groups (3.8±1.9 mSv and 3.9±2.1 mSv in groups 1 and 2, respectively, p=0.75)

Conclusions

The whole-heart-coverage scanner could evaluate coronary arteries with high image quality and without increase in radiation exposure in AF patients, even in the high HR group.

Key points

• Last-generation CT scanner improves coronary artery assessment in AF patients.
• The new CT scanner enables low radiation exposure in AF patients.
• Diagnostic ICA maybe avoided in AF patients with suspected CAD.
• Whole-heart coverage CT scanner enables low radiation exposure in AF patients.
Literatur
1.
Zurück zum Zitat Al-Mallah MH, Aljizeeri A, Villines TC, Srichai MB, Alsaileek A (2015) Cardiac computed tomography in current cardiology guidelines. J Cardiovasc Comput Tomogr 9:514–523CrossRefPubMed Al-Mallah MH, Aljizeeri A, Villines TC, Srichai MB, Alsaileek A (2015) Cardiac computed tomography in current cardiology guidelines. J Cardiovasc Comput Tomogr 9:514–523CrossRefPubMed
2.
Zurück zum Zitat Montalescot G, Sechtem U, Achenbach S et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003CrossRefPubMed Montalescot G, Sechtem U, Achenbach S et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003CrossRefPubMed
3.
Zurück zum Zitat Menke J, Kowalski J (2016) Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose. Eur Radiol 26:451–458CrossRefPubMed Menke J, Kowalski J (2016) Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose. Eur Radiol 26:451–458CrossRefPubMed
4.
Zurück zum Zitat Westwood ME, Raatz HD, Misso K et al (2013) Systematic review of the accuracy of dual-source cardiac CT for detection of arterial stenosis in difficult to image patient groups. Radiology 267:387–395CrossRefPubMed Westwood ME, Raatz HD, Misso K et al (2013) Systematic review of the accuracy of dual-source cardiac CT for detection of arterial stenosis in difficult to image patient groups. Radiology 267:387–395CrossRefPubMed
5.
Zurück zum Zitat Ghadri JR, Küest SM, Goetti R et al (2012) Image quality and radiation dose comparison of prospectively triggered low-dose CCTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition. Int J Cardiovasc Imaging 28:1217–1225CrossRefPubMed Ghadri JR, Küest SM, Goetti R et al (2012) Image quality and radiation dose comparison of prospectively triggered low-dose CCTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition. Int J Cardiovasc Imaging 28:1217–1225CrossRefPubMed
6.
Zurück zum Zitat Yunaga H, Ohta Y, Kaetsu Y et al. (2016) Diagnostic performance of calcification-suppressed coronary CT angiography using rapid kilovolt-switching dual-energy CT. Eur Radiol Yunaga H, Ohta Y, Kaetsu Y et al. (2016) Diagnostic performance of calcification-suppressed coronary CT angiography using rapid kilovolt-switching dual-energy CT. Eur Radiol
7.
Zurück zum Zitat American College of Cardiology Foundation Task Force on Expert Consensus Documents, Mark DB, Berman DS, Budoff MJ et al (2010) ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation 121:2509–2543CrossRef American College of Cardiology Foundation Task Force on Expert Consensus Documents, Mark DB, Berman DS, Budoff MJ et al (2010) ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation 121:2509–2543CrossRef
8.
Zurück zum Zitat Schroeder S, Achenbach S, Bengel F et al (2008) Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuc. Eur Heart J 29:531–556CrossRefPubMed Schroeder S, Achenbach S, Bengel F et al (2008) Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuc. Eur Heart J 29:531–556CrossRefPubMed
9.
Zurück zum Zitat Vorre MM, Abdulla J (2013) Diagnostic accuracy and radiation dose of CT coronary angiography in atrial fibrillation: systematic review and meta-analysis. Radiology 2:376–386CrossRef Vorre MM, Abdulla J (2013) Diagnostic accuracy and radiation dose of CT coronary angiography in atrial fibrillation: systematic review and meta-analysis. Radiology 2:376–386CrossRef
10.
Zurück zum Zitat Di Cesare E, Gennarelli A, Di Sibio A et al (2015) Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: a comparison between patients with chronic atrial fibrillation and subjects in normal sinus rhythm by propensity analysis. Eur J Radiol 84:631–636CrossRefPubMed Di Cesare E, Gennarelli A, Di Sibio A et al (2015) Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: a comparison between patients with chronic atrial fibrillation and subjects in normal sinus rhythm by propensity analysis. Eur J Radiol 84:631–636CrossRefPubMed
11.
Zurück zum Zitat Genders TS, Steyerberg EW, Alkadhi H et al (2011) A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension. Eur Heart J 32:1316–1330CrossRefPubMed Genders TS, Steyerberg EW, Alkadhi H et al (2011) A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension. Eur Heart J 32:1316–1330CrossRefPubMed
12.
Zurück zum Zitat Benz DC, Gräni C, Hirt Moch B et al (2016) Minimized Radiation and Contrast Agent Exposure for Coronary Computed Tomography Angiography: First Clinical Experience on a Latest Generation 256-slice Scanner. Acad Radiol 8:1008–1014CrossRef Benz DC, Gräni C, Hirt Moch B et al (2016) Minimized Radiation and Contrast Agent Exposure for Coronary Computed Tomography Angiography: First Clinical Experience on a Latest Generation 256-slice Scanner. Acad Radiol 8:1008–1014CrossRef
13.
Zurück zum Zitat Andreini D, Pontone G, Mushtaq S et al (2015) Low-dose CT coronary angiography with a novel IntraCycle motion-correction algorithm in patients with high heart rate or heart rate variability. Eur Heart J Cardiovasc Imaging 16:1093–1100CrossRefPubMed Andreini D, Pontone G, Mushtaq S et al (2015) Low-dose CT coronary angiography with a novel IntraCycle motion-correction algorithm in patients with high heart rate or heart rate variability. Eur Heart J Cardiovasc Imaging 16:1093–1100CrossRefPubMed
14.
Zurück zum Zitat Geleijns J, Golding S, Menzel HG, Schibilla H (2000) A workshop on quality criteria for computed tomography held in Arhus, Denmark, November 1998. Eur Radiol 10:544–545CrossRefPubMed Geleijns J, Golding S, Menzel HG, Schibilla H (2000) A workshop on quality criteria for computed tomography held in Arhus, Denmark, November 1998. Eur Radiol 10:544–545CrossRefPubMed
15.
Zurück zum Zitat Halliburton SS, Abbara S, Chen MY et al (2011) SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 5:198–224CrossRefPubMedPubMedCentral Halliburton SS, Abbara S, Chen MY et al (2011) SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 5:198–224CrossRefPubMedPubMedCentral
16.
17.
Zurück zum Zitat Nucifora G, Schuijf JD, Tops LF et al (2009) Prevalence of coronary artery disease assessed by multislice computed tomography coronary angiography in patients with paroxysmal or persistent atrial fibrillation. Circ Cardiovasc Imaging 2:100–106CrossRefPubMed Nucifora G, Schuijf JD, Tops LF et al (2009) Prevalence of coronary artery disease assessed by multislice computed tomography coronary angiography in patients with paroxysmal or persistent atrial fibrillation. Circ Cardiovasc Imaging 2:100–106CrossRefPubMed
18.
Zurück zum Zitat Stolzmann P, Scheffel H, Trindade PT et al (2008) Left ventricular and left atrial dimensions and volumes: comparison between dual-source CT and echocardiography. Invest Radiol 43:284–289CrossRefPubMed Stolzmann P, Scheffel H, Trindade PT et al (2008) Left ventricular and left atrial dimensions and volumes: comparison between dual-source CT and echocardiography. Invest Radiol 43:284–289CrossRefPubMed
19.
Zurück zum Zitat Bertaglia E, Bella PD, Tondo C et al (2009) Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMerge Italian Registry. Europace 11:1004–1010CrossRefPubMed Bertaglia E, Bella PD, Tondo C et al (2009) Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMerge Italian Registry. Europace 11:1004–1010CrossRefPubMed
20.
Zurück zum Zitat Kim R, Park EA, Lee W, Chung JW (2016) Feasibility of 320-row area detector CT coronary angiography using 40 mL of contrast material: assessment of image quality and diagnostic accuracy. Eur Radiol 11:126–134 Kim R, Park EA, Lee W, Chung JW (2016) Feasibility of 320-row area detector CT coronary angiography using 40 mL of contrast material: assessment of image quality and diagnostic accuracy. Eur Radiol 11:126–134
21.
Zurück zum Zitat Zhang LJ, Wang Y, Schoepf UJ et al (2016) 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. Eur Radiol 3:76–87 Zhang LJ, Wang Y, Schoepf UJ et al (2016) 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. Eur Radiol 3:76–87
22.
Zurück zum Zitat Mangold S, De Cecco CN, Schoepf UJ et al. (2017) Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3rd generation dual-source CT. Eur Radiol Mangold S, De Cecco CN, Schoepf UJ et al. (2017) Automated tube voltage selection for radiation dose and contrast medium reduction at coronary CT angiography using 3rd generation dual-source CT. Eur Radiol
23.
Zurück zum Zitat Oncel D, Oncel G, Tastan A (2007) Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation: initial experience. Radiology 245:703–711CrossRefPubMed Oncel D, Oncel G, Tastan A (2007) Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation: initial experience. Radiology 245:703–711CrossRefPubMed
24.
Zurück zum Zitat Yang L, Zhang Z, Fan Z et al (2009) 64-MDCT coronary angiography of patients with atrial fibrillation: influence of heart rate on image quality and efficacy in evaluation of coronary artery disease. AJR Am J Roentgenol 193:795–801CrossRefPubMed Yang L, Zhang Z, Fan Z et al (2009) 64-MDCT coronary angiography of patients with atrial fibrillation: influence of heart rate on image quality and efficacy in evaluation of coronary artery disease. AJR Am J Roentgenol 193:795–801CrossRefPubMed
25.
Zurück zum Zitat Rist C, Johnson TR (2009) Müller-Starck J et al Noninvasive coronary angiography using dual-source computed tomography in patients with atrial fibrillation. Invest Radiol 44:159–167CrossRefPubMed Rist C, Johnson TR (2009) Müller-Starck J et al Noninvasive coronary angiography using dual-source computed tomography in patients with atrial fibrillation. Invest Radiol 44:159–167CrossRefPubMed
26.
Zurück zum Zitat Marwan M, Pflederer T, Schepis T et al (2010) Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography. Eur Heart J 31:2230–2237CrossRefPubMed Marwan M, Pflederer T, Schepis T et al (2010) Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography. Eur Heart J 31:2230–2237CrossRefPubMed
27.
Zurück zum Zitat Zhang JJ, Liu T, Feng Y et al (2011) Diagnostic value of 64-slice dual-source CT coronary angiography in patients with atrial fibrillation: comparison with invasive coronary angiography. Korean J Radiol 12:416–423CrossRefPubMedPubMedCentral Zhang JJ, Liu T, Feng Y et al (2011) Diagnostic value of 64-slice dual-source CT coronary angiography in patients with atrial fibrillation: comparison with invasive coronary angiography. Korean J Radiol 12:416–423CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Xu L, Yang L, Fan Z, Yu W, Lv B, Zhang Z (2011) Diagnostic performance of 320-detector CT coronary angiography in patients with atrial fibrillation: preliminary results. Eur Radiol 21:936–943CrossRefPubMed Xu L, Yang L, Fan Z, Yu W, Lv B, Zhang Z (2011) Diagnostic performance of 320-detector CT coronary angiography in patients with atrial fibrillation: preliminary results. Eur Radiol 21:936–943CrossRefPubMed
29.
Zurück zum Zitat Leipsic J, Labounty TM, Hague CJ et al (2012) Effect of a novel vendor-specific motion-correction algorithm on image quality and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications. J Cardiovasc Computed Tomogr 3:164–171CrossRef Leipsic J, Labounty TM, Hague CJ et al (2012) Effect of a novel vendor-specific motion-correction algorithm on image quality and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications. J Cardiovasc Computed Tomogr 3:164–171CrossRef
30.
Zurück zum Zitat Matsubara K, Sakuda K, Nunome H, Takata T, Koshida K, Gabata T (2016) 128-slice dual-source CT coronary angiography with prospectively electrocardiography-triggered high-pitch spiral mode: radiation dose, image quality, and diagnostic acceptability. Acta Radiol 57:25–32CrossRefPubMed Matsubara K, Sakuda K, Nunome H, Takata T, Koshida K, Gabata T (2016) 128-slice dual-source CT coronary angiography with prospectively electrocardiography-triggered high-pitch spiral mode: radiation dose, image quality, and diagnostic acceptability. Acta Radiol 57:25–32CrossRefPubMed
Metadaten
Titel
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
verfasst von
Daniele Andreini
Gianluca Pontone
Saima Mushtaq
Maria Elisabetta Mancini
Edoardo Conte
Marco Guglielmo
Valentina Volpato
Andrea Annoni
Andrea Baggiano
Alberto Formenti
Valentina Ditali
Marco Perchinunno
Cesare Fiorentini
Antonio L. Bartorelli
Mauro Pepi
Publikationsdatum
21.11.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 4/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5131-2

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