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Updated: Jun 24, 2026
Retrospective Cardiac Gating with A Prototype Small-Animal X-ray Computed Tomograph
Published on: February 21, 2025
A comprehensive electrocardiogram-gated 64-slice multidetector computed tomography imaging protocol to visualize the
Michael D Shapiro1, Jonathan D Dodd, Sanjeeva Kalva
1Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Insights
64-slice computed tomography angiography (CTA) enables simultaneous imaging of coronary arteries, thoracic aorta, and pulmonary arteries. This coronary, aorta, pulmonary (CAP) CTA protocol achieves excellent image quality comparable to standard CTA, potentially improving patient triage.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Thoracic Imaging
Background:
- Computed tomography (CT) advancements allow for comprehensive thoracic imaging.
- Evaluating coronary disease, aortic dissection, and pulmonary embolism often requires separate CT angiography (CTA) protocols.
Purpose of the Study:
- To assess if 64-slice CT angiography can simultaneously visualize coronary, aorta, and pulmonary arteries (CAP CTA).
- To compare the image quality of CAP CTA with dedicated coronary and pulmonary CTA protocols.
Main Methods:
- Prospective enrollment of 20 patients for CAP CTA.
- Qualitative and quantitative assessment of CAP CTA image quality.
- Comparison with matched control datasets from dedicated coronary and pulmonary CTA.
Main Results:
- CAP CTA demonstrated comparable image quality to dedicated coronary CTA for coronary arteries and thoracic aorta.
- No significant difference in overall image quality or motion artifacts was observed.
- Higher contrast attenuation was noted in pulmonary arteries with CAP CTA compared to standard pulmonary CTA.
Conclusions:
- Individually tailored single contrast injection for CAP CTA allows excellent simultaneous visualization of coronary arteries, thoracic aorta, and pulmonary arteries.
- Further research is needed to evaluate CAP CTA's role in triaging patients with acute chest pain.
Objectives:
Advances in computed tomography technology may permit the evaluation of coronary disease, aortic dissection, and pulmonary embolism with a single contrast bolus and breath hold. We sought to determine whether 64-slice computed tomography angiography (CTA) allows for simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries (coronary, aorta, pulmonary [CAP]) with image quality comparable to routine CTA protocols.
Materials And Methods:
We prospectively enrolled 20 patients who underwent CAP CTA. Image quality of CAP CTA was assessed qualitatively and quantitatively and compared with dedicated coronary (n = 20) and pulmonary (n = 10) CTA data sets using matched controls.
Results:
The mean amount of contrast and radiation dose was 132 +/- 10 mL and 17.8 +/- 1.8 mSv, 78 +/- 9 mL and 13.7 +/- 3.4 mSv, and 135 mL and 11.9 +/- 1.5 mSv for CAP CTA, coronary CTA, and pulmonary CTA, respectively (P = 0.001). There was no difference in overall image quality (P = 0.88), presence of motion artifacts (P = 0.40), or enhancement of the proximal coronary arteries (median [interquartile range for contrast-noise ratio was 12.5 9.9-15.2 vs 13.1 10.3-16.9; P = 0.17]) or thoracic aorta (264 [113-326] vs 245 [107-295]; P = 0.34) between CAP CTA and the dedicated coronary CTA, respectively. However, contrast attenuation was higher in the pulmonary arteries with CAP CTA (363 [253-424]) versus the standard pulmonary CTA protocol (235 [182-269]; P = 0.0001).
Conclusions:
: Using an individually tailored single contrast injection, CAP CTA permits simultaneous visualization of the coronary arteries, thoracic aorta, and pulmonary arteries with excellent image quality. Further research is necessary to determine whether this protocol may enhance triage of patients with undifferentiated acute chest pain.
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