Chest Circumference as a Predictive Parameter of Computed Tomography Coronary Angiography Radiation Doses from Dual-Source Computed Tomography

Sagsoz, M. Erdem; Bayraktutan, Ummugulsum; Oğul, Hayri; Kantarcı, Mecit

doi:10.5152/eajm.2013.07

Cited by 5 publications

(7 citation statements)

References 20 publications

(24 reference statements)

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“…Currently, the best images and low radiation doses are produced by 256-slice, dualsource MDCT, prospectively ECG-triggered acquisition, and a high pitch value of 3.2 or 3.4. 17 We found that low-dose, 256-slice, dual-source MDCT readily enabled evaluation of the coronary arteries and mediastinum in our young female patient with ECD.…”

Section: Fig 2 Multidetector Computed Tomographic Images A) Reformamentioning

confidence: 66%

Multidetector Computed Tomographic Imaging of Erdheim-Chester Disease

Yüceler

Kantarcı

Karabulut

et al. 2014

Texas Heart Institute Journal

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E rdheim-Chester disease (ECD) is a rarely reported form of multisystemic, non-Langerhans-cell histiocytosis. The clinical manifestations range from no symptoms to life-threatening conditions. Involvement of the bones, lungs, retro-orbital space, perirenal space, nervous system, cardiovascular system, and skin has particularly been observed. The cardiovascular involvement of ECD is probably more frequent than was originally thought; technological advances in multidetector computed tomography (MDCT) have enabled better views of patients' coronary arteries at low radiation doses. We report the case of a young woman in whom we used 256-slice, dual-source MDCT with high pitch value to evaluate the coronary arteries and reveal the effects of ECD. Case ReportIn April 2013, a previously healthy 29-year-old woman was referred to our hospital with a 3-month history of progressive angina. She had no history of other medical illnesses or familial diseases. Results of physical examination, laboratory tests, electrocardiography (ECG), and echocardiography were normal. To analyze her coronary arteries, we used a 256-slice Somatom ® Definition Flash MDCT system (Siemens Medical Solutions; Forchheim, Germany) with a high pitch value of 3.2. The patient's effective radiation dose was 1.1 mSv for the cardiac imaging. The MDCT angiogram revealed large mediastinal soft tissue with muscle attenuation surrounding the ascending aorta, extending into the proximal segment of the left main coronary artery, and causing stenosis by compressing the proximal segment of the left anterior descending coronary artery (Figs. 1 and 2). This periaortic effect resembles "coated aorta," associated with ECD. A specimen from a computed tomographic-guided biopsy of the mediastinal mass displayed fibrosis and many foamy histiocytes (CD68 + and CD1a -). The imaging and histologic findings supported the diagnosis of ECD. Skeletal radiographs showed no bone involvement, and thoracoabdominal computed tomograms and magnetic resonance images of the brain and orbit revealed no effect on those organs. The patient was referred for hemato-oncologic treatment. She was subsequently lost to follow-up. DiscussionTo our knowledge, this is the first report of the use of low-dose, dual-source, 256-slice multidetector computed tomography to characterize Erdheim-Chester disease

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Section: Fig 2 Multidetector Computed Tomographic Images A) Reformamentioning

confidence: 66%

Multidetector Computed Tomographic Imaging of Erdheim-Chester Disease

Yüceler

Kantarcı

Karabulut

et al. 2014

Texas Heart Institute Journal

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“…In the present study, we applied coronary CTA with a high-pitch value and a prospective ECG-triggered spiral data acquisition. This reduces radiation exposure to a minimum value because no overlap occurs in the data sampling (12,24,25).…”

Section: Radiation Dosesmentioning

confidence: 99%

“…In the following years, hasty upgrading has taken place in CT technology, which has led to improved sequential and unique image quality and efficiency because of condensed attainment time (11). In 2002 and 2004, there followed the introduction of 16-slice and 64-slice scanners, which allowed a rotation time of about 330-420 ms (12). This was believed to be an excellent apparatus for CT visualization in the examination of coronary arteries.…”

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confidence: 99%

Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Selcuk

Otcu

Yüceler³

et al. 2016

Balkan Med J

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Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology. Aims: In this study, we aimed to examine the accuracy and image quality of high-pitch 128-slice dual-source CTA taking the ICA as reference technique. We also aimed to compare the accuracy and image quality between different heart rate groups of >70 beates per minute (bpm) and ≤70 bpm. Study Design: Retrospective cross-sectional study. Methods: Among 450 patients who underwent coronary CTA with the FLASH spiral technique, performed with a second generation dual-source computed tomography device with a pitch value of 3.2, 102 patients without stent and/or bypass surgery history and clinically suspected coronary artery disease who underwent ICA within 15 days were enrolled. Image quality was assessed by two independent radiologists using a 4-point scale (1=absence of any artifacts-4=non-evaluable). A stenosis >50% was considered significant on a per-segment, per-vessel, and per-patient basis and ICA was considered the reference method. Radiation doses were determined using dose length product (DLP) values detected by the computed tomography (CT) device. In addition, patients were classified into two groups according to their heart rates as ≤70 bpm (73 patients) and >70 bpm (29 patients). The relation between the diagnostic accuracy and heart rate groups were evaluated. Results: Overall, 1495 (98%) coronary segments were diagnostic in 102 patients (32 male, 70 female, mean heart rate: 65 bpm). There was a significant correlation between image quality and mean heart rate in the right coronary artery (RCA) segments. The effective radiation dose was 0.98±0.09 mili Sievert (mSv). On a per-patient basis, sensitivity, specificity, and positive and negative predictive values were 93.8%, 88.8%, 93.8% and 88.8%, respectively. These values were also similar in per-vessel and per-segment basis. Two different groups categorized by mean heart rate had almost similar results in terms of the diagnostic power of dual-source CTA. Conclusion: CTA with a high pitch value is a reliable, non-invasive diagnostic method that can CAD with low radiation doses not only in patients with a heart rate below 70 bpm, but also in patients with higher heart rates. Keywords: Computed tomography angiography, coronary arteries, high-pitch, low radiation dose, heart rate Copyright 2016 © Trakya University Faculty of Medicine Balkan Med J 201633: 283-93 Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

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“…Common parameters that can contribute to reducing the dose received via a CT include tube current, tube rotation time, peak voltage, pitch, and collimation. Electrocardiography used for tube current modulation can be applied because the prospective axial scan and high-pitch spiral scan include repeated CT data and added exposure (11,12). Based on the results of this study, we can add one more parameter to cardiac MDCT angiography examinations: the tube position during the scanogram image.…”

Section: Discussionmentioning

confidence: 93%

Radiation dose to breasts from a cardiac computed tomography angiographyscanogram can be reduced by switching tube position

Sagsoz

Pirimoğlu

2016

Turk J Med Sci

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Background/aim: In a computed tomography (CT) examination, scanogram images are used to determine the range of the area to be imaged before scanning. The importance of scanogram image exposure has increased since total examination radiation has decreased due to technological advancements. The purpose of this study was to determine and compare radiation doses delivered to patients while the tube was in anterior-posterior (AP) and posterior-anterior (PA) positions during a CT angiography scanogram. Materials and methods:The radiation doses absorbed by the breast tissue of 55 female patients who underwent cardiac dual-source computed tomography (DSCT) angiography were determined using thermoluminescent dosimeters (TLD-100, Harshaw, MA, USA). Four patients were excluded from the study for various reasons.Results: Radiation doses absorbed by the breasts were significantly lower when the tube position was switched during the scanogram. The absorbed doses, calculated from scanogram exposures, were 520 ± 50 µSv for the AP projection and 410 ± 45 µSv for the PA projection. Total skin doses from the DSCT examinations were 18.9 ± 2.3 mSv. Conclusion:We attributed the approximately 20% lower doses to the position of the scanogram tube, which was in the PA position.

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Chest Circumference as a Predictive Parameter of Computed Tomography Coronary Angiography Radiation Doses from Dual-Source Computed Tomography

Cited by 5 publications

References 20 publications

Multidetector Computed Tomographic Imaging of Erdheim-Chester Disease

Multidetector Computed Tomographic Imaging of Erdheim-Chester Disease

Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Radiation dose to breasts from a cardiac computed tomography angiographyscanogram can be reduced by switching tube position

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