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Published on: January 6, 2019
Double prospectively ECG-triggered high-pitch spiral acquisition for CT coronary angiography: initial experience
Insights
Double prospectively triggered high-pitch mode offers excellent image quality for coronary CT angiography. This advanced technique achieves low effective radiation doses, making it a safe and effective option for cardiac imaging.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Physics
Background:
- Coronary computed tomography angiography (CTCA) is crucial for diagnosing coronary artery disease.
- Optimizing CTCA protocols is essential for balancing image quality and radiation dose.
- High-pitch spiral acquisition modes aim to reduce scan time and radiation exposure.
Purpose of the Study:
- To assess the feasibility of a double prospectively electrocardiogram (ECG)-triggered high-pitch spiral acquisition mode for CTCA.
- To evaluate the image quality and radiation dose associated with this novel acquisition technique.
Main Methods:
- 149 patients underwent CTCA using a dual-source CT system with a double high-pitch mode (triggered at 60% and 30% of the R-R interval).
- Image quality was assessed using a four-point scale.
- Effective radiation dose was calculated, and contrast medium volume was recorded.
Main Results:
- Excellent image quality was achieved in 86.4% of coronary artery segments (score 1).
- The average image quality score was 1.15 ± 0.26.
- The mean effective radiation dose was 3.5 ± 0.8 mSv, with a mean contrast volume of 78.7 ± 2.9 ml.
Conclusions:
- The double prospectively ECG-triggered high-pitch spiral acquisition mode is feasible for CTCA.
- This method yields good image quality with an average effective dose below 5 mSv in patients with heart rates ≤70 bpm.
- It represents a promising advancement for radiation dose reduction in cardiac CT imaging.
Aim:
To evaluate the feasibility of double prospectively electrocardiogram (ECG)-triggered high-pitch spiral acquisition mode (double high-pitch mode) for coronary computed tomography angiography (CTCA).
Materials And Methods:
One hundred and forty-nine consecutive patients [40 women, 109 men; mean age 58.2 ± 9.2 years; sinus rhythm ≤70 beats/min (bpm) after pre-medication, body weight ≤100 kg] were enrolled for CTCA examinations using a dual-source CT system with 2 × 128 × 0.6 mm collimation, 0.28 s rotation time, and a pitch of 3.4. Double high-pitch mode was prospectively triggered first at 60% and later at 30% of the R-R interval within two cardiac cycles. Image quality was evaluated using a four-point scale (1 = excellent, 4 = non-assessable).
Results:
From 2085 coronary artery segments, 86.4% (1802/2085) were rated as having a score of 1, 12.3% (257/2085) as score of 2, 1.2% (26/2085) as score of 3, and none were rated as "non-assessable". The average image quality score was 1.15 ± 0.26 on a per-segment basis. The effective dose was calculated by multiplying the coefficient factor of 0.028 by the dose-length product (DLP); the mean effective dose was 3.5 ± 0.8 mSv (range 1.7-7.6 mSv). The total dosage of contrast medium was 78.7 ± 2.9 ml.
Conclusion:
Double prospectively ECG-triggered high-pitch spiral acquisition mode provides good image quality with an average effective dose of less than 5 mSv in patients with a heart rate ≤70 bpm.
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