Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate

Carrascosa, Patrícia; Capuñay, Carlos; Deviggiano, Alejandro; Goldsmit, Alejandro; Tajer, Carlos; Bettinotti, Marcelo; Carrascosa, Jorge; Ivanc, Thomas B.; Fallahi, Arzhang; García, Mario J.

doi:10.1016/j.jcct.2010.04.001

Cited by 32 publications

(23 citation statements)

References 37 publications

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“…(2,(5)(6)(7)(8)(9)14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) The attrition diagram for our study depicting the search process is shown in Fig. 2 Table III.…”

Section: Resultsmentioning

confidence: 99%

“…(9,19,26,27) The mean SNR of these four studies was 20.9 (95% CI 11.7-28.6) while the mean CNR was 18.0 (95% CI 5.2-22.2). There was no significant difference between the SNR and CNR values of these studies.…”

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 90%

“…There was no significant difference between the SNR and CNR values of these studies. SNR and CNR were measured at the proximal segment of the right coronary artery and in the left main coronary artery, left ventricular wall and left ventricular chamber, (19) the root of the ascending aorta, (27) ascending aorta, pulmonary artery and coronary arteries, (26) and ascending aorta and perivascular fatty tissue. (9) Qualitative image quality evaluations could not be analysed due to the limited number of studies that provided relevant information.…”

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

“…(20) Among the other 22 studies, 15 assessed interobserver agreement using the Cohen's kappa statistic (mean 0.8, 95% CI 0.6-0.9), indicating excellent agreement between two viewers in these studies. (2,(7)(8)(9)19,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) Two studies used consensus reading. (21,22) However, pertinent information was not available in the remaining five studies that met our selection criteria.…”

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

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Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Sabarudin

Sun

2013

SMedJ

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Singapore Med J 2013; 54(1) : 15 R ev iew A r tic le INTRODUCTIONCoronary computed tomography angiography (CCTA) has been widely used as a valuable diagnostic imaging modality for the noninvasive assessment of coronary artery disease (CAD). It has become a reliable and accurate modality to assess the coronary arteries of patients with suspected CAD.(1) Previous studies have found that retrospective electrocardiography (ECG)-gated CCTA provides high sensitivity (range 86%-99%) and specificity (range 89%-100%) for coronary artery stenosis, and also results in high negative predictive values (NPVs; range 96%-99%).(2,3)Prospective ECG-gated CCTA also promises high sensitivity (range 93.7%-100.0%), specificity (range 82.7%-97.0%) and NPV (range 95%-98%) in the assessment of CAD. (2,3) Although high diagnostic accuracy is achieved with both retrospective and prospective ECG-gated CCTA for detecting CAD (Fig. 1), the radiation doses associated with these two cardiac examinations are significantly different due to the different approaches used for coronary artery scanning.It is well known that CCTA with retrospective ECG gating leads to high radiation doses of up to 31.4 mSv since volumetric data of the heart is acquired during continuous scans in this modality, although only a portion of the data is used for reconstruction. (4,5) In contrast, with exposure taking place at selective phases of the cardiac cycle in patients with low and regular heart rate, prospective ECG triggering is associated with very low radiation doses, which indicates a significant reduction in effective doses of up to 87%. (6) Several studies that used prospective ECG-gated CCTA have reported significantly reduced radiation doses. (7)(8)(9)(10)(11)(12) However, the diagnostic image quality of prospective triggering in the assessment of coronary arteries or CAD has not been systematically studied. Therefore, the purpose of this study was to investigate previous studies that assessed the coronary artery using prospective ECG-triggered CCTA for the detection of CAD, in terms of image quality and radiation dose via a systematic review of the current literature. METHODS Literature searchA ABSTRACT The purpose of this study was to perform a systematic review of the diagnostic accuracy, image quality and radiation dose of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA). We searched databases containing studies of CCTA that used prospective ECG-triggering between 2008 and 2011. The effective dose and image quality reported in each study were analysed and compared between the types of multislice CT scanners. We identified 23 studies through this search, with mean assessable coronary segments and effective dose at 96.8% (95% confidence level [CI] 83%, 100%) and 3.6 mSv (95% CI 2.9, 4.3 mSv), respectively. Both quantitative and qualitative assessments of image quality indicated that image quality was achieved in studies using prospective ECG-triggered CCTA, regardless of the type of CT scanners. The pooled es...

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“…(2,(5)(6)(7)(8)(9)14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) The attrition diagram for our study depicting the search process is shown in Fig. 2 Table III.…”

Section: Resultsmentioning

confidence: 99%

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 90%

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

Section: Systematic Review Of Image Quality Associated With Prospectimentioning

confidence: 99%

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Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Sabarudin

Sun

2013

SMedJ

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“…Todos los exámenes fueron realizados con una potencia de tubo de 120 kV lo que no sucede en otros estudios donde la modulación de la potencia del tubo a 100 kV obtiene reducciones de hasta un 20 % lo que significa que se pueden realizar estudios a menos de 4 mSv [12] lo que podría significar que si aplicamos esta técnica se obtuviese un promedio de 10.9 mSv en este estudio.…”

Section: Discussionunclassified

Estudio Descriptivo: Dosis Efectiva de Radiación en Angiotomografías Coronarias Multidetector de Enero del 2013 a Diciembre del 2015 en el Hospital de Especialidades José Carrasco Arteaga

et al. 2017

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134 RESUMEN INTRODUCCIÓN:La coronariografia convencional sigue siendo el patrón de referencia para cuantificar y guiar el tratamiento en la enfermedad coronaria sin embargo con la introducción de la angiotomografía coronaria multidetector en la valoración de placas ateromatosas coronarias y con esto la exposición a la radiación ha permanecido como área de constante preocupación. En la práctica diaria se recomienda basarse en lo que se conoce como As Low As Reasonably Achievable que significa optimizar la radiación sin perjuicio de la calidad del estudio. MÉTODOS:Se trata de un estudio descriptivo retrospectivo en el Hospital de Especialidades José Carrasco Arteaga de Cuenca -Ecuador, durante el periodo de tiempo comprendido entre el 01 enero del 2013 y 31 diciembre del 2015. Para este estudio se incluyeron todos los pacientes a quienes se les realizó angiotomografía coronaria multidetector, se recolectaron los datos clínicos y la dosis efectiva de radiación de cada paciente. RESULTADOS:La edad promedio fue de 63.2 años. Con una probabilidad pre-test intermedia-baja para enfermedad coronaria en más del 94 % de los pacientes, de los cuales el promedio de dosis de radiación efectiva en angiotomografía coronaria multidetector es de 13.0276 mSv (0.9002 -20.657). CONCLUSION:Se trata del primer estudio en el medio donde investiga la dosis de radiación utilizada en angiotomografía coronaria multidetector permitiendo conocer la media de dosis efectiva y así optimizar la misma mediante técnicas de reducción. . DESCRIPTORES CONCLUSIONS:This is the first study in our area where the dose of radiation used in multidetector coronary angiothomography has been investigated, making it possible to identify the effective half dose, in this way optimizing the same through the use of reduction techniques.

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Alteration of type I interferon response is associated with subclinical atherosclerosis in virologically suppressed HIV‐1‐infected male patients

Santinelli

Girolamo

Borrazzo

et al. 2021

Journal of Medical Virology

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Given human immunodeficiency virus‐1 (HIV‐1)‐infected patients have alterations in the type I interferon (IFN‐I) pathway and are also at elevated risk of atherosclerosis, we evaluated IFN‐I response and subclinical cardiovascular disease (CVD) association in HIV‐1‐infected patients. Transcript levels of IFN‐α/β and IFN‐stimulated gene 56 (ISG56) were evaluated by RT/real‐time PCR in peripheral blood mononuclear cells collected from asymptomatic HIV‐1‐positive male patients at high risk of developing CVD (n = 34) and healthy subjects (n = 21). Stenosis degree (≥ or <50%), calcium volume score, calcium Agatston score, and myocardial extracellular volume were examined by coronary computerized tomography scan. Carotid intima‐media thickness (cIMT), Framingham risk score, atherosclerotic cardiovascular disease (ASCVD) score, and risk score developed by data collection on adverse effects of anti‐HIV drugs (D:A:D) were also measured. Increased IFN‐α, IFN‐β, and ISG56 levels were observed in all HIV‐1‐infected males compared to healthy controls (p < .001 for all genes analyzed). HIV‐1‐infected patients with a stenosis degree ≥50% showed a higher Framingham risk score (p = .019), which was correlated with IFN‐β and ISG56 levels. HIV‐1‐infected males with enhanced IFN‐I levels and stenosis displayed a higher ASCVD calculated risk (p = .011) and D:A:D score (p = .004). Also, there was a trend toward higher IFN‐α and ISG56 mRNA levels in HIV‐1‐positive patients with an increased cIMT (p > .05). Dysregulation of IFN‐I response might participate in the pathogenesis of HIV‐1‐associated CVD.

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Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate

Cited by 32 publications

References 37 publications

Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Coronary computed tomography angiography with prospective electrocardiography triggering: a systematic review of image quality and radiation dose

Estudio Descriptivo: Dosis Efectiva de Radiación en Angiotomografías Coronarias Multidetector de Enero del 2013 a Diciembre del 2015 en el Hospital de Especialidades José Carrasco Arteaga

Alteration of type I interferon response is associated with subclinical atherosclerosis in virologically suppressed HIV‐1‐infected male patients

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