Prospectively gated axial CT coronary angiography: preliminary experiences with a novel low-dose technique

To assess image quality and radiation exposure with prospectively gated axial CT coronary angiography (PGA) compared to retrospectively gated helical techniques (RGH). Forty patients with suspected coronary artery disease (CAD) and a stable heart rate below 65 bpm underwent CT coronary angiography (CTCA) using a 64-channel CT system. The patient cohort consisted of 20 consecutive patients examined using a PGA technique and 20 patients examined using a standard RGH technique. Both groups were matched demographically according to age, gender, body mass index, and heart rate. For both groups, two independent observers assessed image quality for all coronary segments on an ordinal scale from 1 (nonassessable) to 5 (excellent quality). Image quality and radiation exposure were compared between patient groups. There were no significant differences in vessel-based image quality between the two groups (P > 0.05). Mean (+/- SD) effective radiation exposure in the PGA group was 3.7 +/- 0.8 mSv compared to 18.9 +/- 3.8 mSv in the RGH group without ECG-based tube current modulation (P < 0.001). Preliminary experience shows PGA technique to be a promising approach for CTCA resulting in a substantial reduction in radiation exposure with image quality comparable to that of standard RGH technique.