ECG-triggered high-pitch CT for simultaneous assessment of the aorta and coronary arteries

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Computed tomography (CT) is crucial for cardiovascular assessment.
• Optimizing image quality and radiation dose in CT angiography remains a key challenge.
• ECG-gated CT techniques aim to improve visualization of dynamic cardiac structures.

Purpose of the Study:

• To evaluate the image quality of high-pitch ECG-gated CT for simultaneous imaging of the aorta and coronary arteries.
• To assess the diagnostic accuracy of this technique for detecting coronary artery stenosis.
• To determine the radiation dose associated with this imaging protocol.

Main Methods:

• Eighty-four patients underwent high-pitch ECG-gated CT without beta-blockers.
• Iterative reconstruction algorithms were employed.
• Contrast-to-noise ratio (CNR) was measured for the aorta and coronary arteries.
• Image quality was graded, and findings were compared with coronary angiography in a subset of patients.

Main Results:

• High-pitch acquisition yielded a mean dose-length product (DLP) of 234 ± 93 mGy·cm (4.2 mSv).
• Excellent image quality was achieved in 94% of patients for the aorta and 96% of coronary artery segments.
• The technique demonstrated high sensitivity (97%) and specificity (98%) for detecting significant coronary artery stenoses.

Conclusions:

• High-pitch ECG-gated CT enables accurate visualization of both the aorta and coronary arteries in a single acquisition.
• The method achieves this with limited radiation dose, even in patients with higher heart rates and without beta-blocker administration.
• Radiologists should consider reporting coronary artery disease findings during aortic CT examinations.