Related Experiment Video
Updated: Mar 21, 2026
Retrospective Cardiac Gating with A Prototype Small-Animal X-ray Computed Tomograph
Published on: February 21, 2025
High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT
Veit Sandfort1, Mark A Ahlman1, Elizabeth C Jones1
1Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA.
Insights
High-pitch computed tomography (CT) of the chest effectively visualizes myocardial structure and coronary arteries. This advanced imaging technique offers improved cardiac detail on non-gated scans, potentially aiding incidental cardiac findings.
Area of Science:
- Radiology and Imaging Science
- Cardiovascular Imaging
- Medical Physics
Background:
- Chest CT scans are standard in radiology but lack detailed cardiac imaging.
- Advancements in CT technology are exploring enhanced visualization of non-cardiac structures.
Purpose of the Study:
- To assess the visualization of myocardial and coronary arteries using high-pitch, non-gated CT with 3rd generation dual-source technology.
- To compare image quality and radiation dose between high-pitch and conventional-pitch chest CT scans.
Main Methods:
- Evaluation of cardiac anatomy in patients who underwent 3rd generation, non-gated, high-pitch contrast-enhanced chest CT.
- Comparison with prior conventional (low-pitch) chest CT scans from chest abdomen pelvis exams.
- Image features of cardiac structures were scored by blinded reviewers, with paired analysis performed.
Main Results:
- High-pitch CT demonstrated superior visualization scores for all cardiovascular structures compared to conventional pitch scans.
- Coronary arteries were visualized in significantly more segments (9 vs. 2) with high-pitch CT.
- High-pitch CT resulted in lower radiation exposure with comparable image noise.
Conclusions:
- Non-gated 3rd generation chest CT frequently visualizes myocardial structure and coronary arteries.
- The findings suggest a potential role for routine cardiac interpretation on chest CTs obtained for non-cardiac indications.
- Further investigation is warranted to establish guidelines for cardiac assessment during routine chest CTs.
Background:
Chest CT scans are frequently performed in radiology departments but have not previously contained detailed depiction of cardiac structures.
Objectives:
To evaluate myocardial and coronary visualization on high-pitch non-gated CT of the chest using 3rd generation dual-source computed tomography (CT).
Methods:
Cardiac anatomy of patients who had 3rd generation, non-gated high pitch contrast enhanced chest CT and who also had prior conventional (low pitch) chest CT as part of a chest abdomen pelvis exam was evaluated. Cardiac image features were scored by reviewers blinded to diagnosis and pitch. Paired analysis was performed.
Results:
3862 coronary segments and 2220 cardiac structures were evaluated by two readers in 222 CT scans. Most patients (97.2%) had chest CT for oncologic evaluation. The median pitch was 2.34 (IQR 2.05, 2.65) in high pitch and 0.8 (IQR 0.8, 0.8) in low pitch scans (p < 0.001). High pitch CT showed higher image visualization scores for all cardiovascular structures compared with conventional pitch scans (p < 0.0001). Coronary arteries were visualized in 9 coronary segments per exam in high pitch scans versus 2 segments for conventional pitch (p < 0.0001). Radiation exposure was lower in the high pitch group compared with the conventional pitch group (median CTDIvol 10.83 vs. 12.36 mGy and DLP 790 vs. 827 mGycm respectively, p < 0.01 for both) with comparable image noise (p = 0.43).
Conclusion:
Myocardial structure and coronary arteries are frequently visualized on non-gated 3rd generation chest CT. These results raise the question of whether the heart and coronary arteries should be routinely interpreted on routine chest CT that is otherwise obtained for non-cardiac indications.
More Related Videos
11:09High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
Published on: December 16, 2022
09:32Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...