Comprehensive low-dose imaging of carotid and coronary arteries with a single-injection dual-source CT angiography protocol

Tognolini, Alessia; Arellano, Cesar; Marfori, Wanda; Heidari, G.; Sayre, James W.; Krishnam, Mayil S.; Ruehm, Stefan G.

doi:10.1016/j.crad.2013.10.004

Cited by 10 publications

(11 citation statements)

References 46 publications

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“…Increasing the injection rate could also shift the TDC to the left and up. According to the above adjustments, the present study improved the arterial attenuation when compared with those observed in previous studies (10–13); the contrast agent volume was reduced significantly in the present study.…”

Section: Discussionsupporting

confidence: 69%

“…However, these studies were conservative with a high tube voltage (100 or 120 kV) and high concentration contrast agent (370 mg/ml), and did not utilize the advantages of 128-slice DSCT, particularly by combining the iterative algorithm and ultra-low tube voltage to reduce the radiation dose for the patients of standard body type. Cardiovascular and cerebrovascular imaging was also performed with 256-slice CT and first-generation DSCT, with a higher radiation dose and amount of the contrast agent when compared with those of the second-generation DSCT (12,13).…”

Section: Introductionmentioning

confidence: 99%

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Ultra‑low dose one‑step CT angiography for coronary, carotid and cerebral arteries using 128‑slice dual‑source CT: A feasibility study

et al. 2019

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Atherosclerotic diseases are systemic and patient outcomes depend on comprehensive imaging evaluation. Computed tomography angiography (CTA) is a powerful tool used to assess atherosclerosis. However, the scanning protocol is designed for cardiovascular and cerebrovascular imaging, which require considerations into the radiation dose, contrast agent and image quality. The purpose of the present study was to evaluate ultra-low dose one-step CTA for coronary, carotid and cerebral arteries with a low concentration contrast agent. A total of 78 patients were enrolled and randomly divided into two groups: Group A (n=38) and B (n=40). High-pitch CTA for coronary, carotid and cerebral arteries with a tube voltage of 70 or 80 kVp and 40 ml contrast agent (270 mgI/ml) was performed by a 128-slice dual-source CT scanner for group A. Standard high-pitch CTA with a tube voltage of 100 kVp and 60 ml contrast agent (370 mgI/ml) was conducted for group B. The image quality, radiation dose and amount of contrast agent in group A were evaluated and compared with group B. The dose length product for groups A and B was 62.95±21.54 vs. 160.15±15.13 mGy cm, respectively (t=−23.157, P<0.001). The mean total iodine content was 10.8±0 mg for group A and 22.2±0 mg for group B. In total, 99.4% of the arterial segments could be assessed for the two groups ( χ 2 =0.267, P=0.606). The results revealed that ultra-low dose one-step high-pitch CTA can provide assessable image quality, and minimize the radiation dose and contrast agent.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Ultra‑low dose one‑step CT angiography for coronary, carotid and cerebral arteries using 128‑slice dual‑source CT: A feasibility study

et al. 2019

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“…32 In several reports, this technique, applied to carotid arteries, resulted feasible and accurate in the evaluation of plaque composition. 33 Plaque enhancement following contrast injection is also an extremely promising imaging parameter: symptomatic plaques have a significantly higher degree of plaque enhancement following contrast administration than asymptomatic plaques, indicating a greater degree of vascularization. 34 Nuclear and molecular imaging Cellular/molecular imaging attempts at visualizing specific biological processes occurring within the plaque in vivo and holds the promise of earlier and more specific diagnoses.…”

Section: Newer Emerging Ultrasound-based Techniquesmentioning

confidence: 99%

Imaging of the vulnerable carotid plaque

et al. 2020

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ObjectivesAtherothrombosis in the carotid arteries is a main cause of ischemic stroke and may depend on plaque propensity to complicate with rupture or erosion, in turn related to vulnerability features amenable to in vivo imaging. This would provide an opportunity for risk stratification and—potentially—local treatment of more vulnerable plaques. We here review current information on this topic.MethodsWe systematically reviewed the literature for concepts derived from pathophysiologic, histopathologic, and clinical studies on imaging techniques attempting at identifying vulnerable carotid lesions.ResultsUltrasound, MRI, CT, and nuclear medicine–based techniques, alone or with multimodality approaches, all have a link to pathophysiology and describe different—potentially complementary—aspects of lesions prone to complications. There is also, however, a true paucity of head-to-head comparisons of such techniques for practical implementation of a thorough and cost-effective diagnostic strategy based on evaluation of outcomes. Especially in asymptomatic patients, major international societies leave wide margins of indecision in the advice to techniques guiding interventions to prevent atherothrombotic stroke.ConclusionsTo improve practical management of such patients—in addition to the patient's vulnerability for systemic reasons—a more precise identification of the vulnerable plaque is needed. A better definition of the diagnostic yield of each imaging approach in comparison with the others should be pursued for a cost-effective translation of the single techniques. Practical translation to guide future clinical practice should be based on improved knowledge of the specific pathophysiologic correlates and on a comparative modality approach, linked to subsequent stroke outcomes.

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“…For the images of patients whose heart rates exceed 100 bpm, extensive post-processing is required. As previously described, the mean effective radiation dose of ~1.17 mSv is higher than the mean radiation dose applied in this study (25,37). Notably, 320-MSCT allows CT angiography examination to be performed at high-pitch values of 3.4, and at a scanning rate of up to 43 cm/sec (38).…”

Section: Grade ------------------------------------------------------mentioning

confidence: 88%

Application of low-dose dual-source computed tomography angiography in children with complex congenital heart disease

Chen

Jiang

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The objective of the present study was to evaluate image quality and radiation dosage using a low-dose prospectively electrocardiogram (ECG)-gated computed tomography (CT) protocol for dual-source angiography in children with complex congenital heart disease. A total of 206 patients with complex congenital heart disease were equally assigned into two groups at random. The children in group A underwent low-dose retrospective ECG-gated CT scanning with an ECG-pulsing technique, and group B underwent prospective ECG-gated scanning with an ECG-pulsing technique. Radiation dose volume computed tomography dose index (CTDI vol), dose length product (DLP) and effective dose (ED) were recorded after scanning. Raw data were transferred to workstations for post-processing, diagnosis, grading, comparison with intra-operation findings or cardiac catheterisation, and the coincidence, false negative rate and misdiagnosis rates of groups A and B, respectively, were subsequently recorded. The results of the present study indicated that the height, age and weight of the children in the two groups exhibited no significant differences. The image quality of group A was graded as 3.94±0.08, whereas the grade for the image quality in group B was 4.05±0.08; no significant difference was detected. The coincidence rates of groups A and B were 89.37 and 88.48%, respectively; the false negative rates of groups A and B were 9.66 and 10.60%, respectively; the misdiagnosis rates of groups A and B were 0.97 and 0.92%. No significant differences between the two groups were detected. The CTDI value of group A was 3.24±1.62 mGy, the DLP value was 47.53±33.28 mGy·cm 2 , the ED value was 0.93±0.42 mSv. By contrast, the CTDI value of group B was 2.27±0.94 mGy, the DLP value was (27.03±17.64) mGy·cm 2 , and the ED value was 0.53±0.23 mSv. Significant differences were detected between the two groups (CTDI t=5.287, P<0.05; DLP t=5.523, P<0.05; ED t=8.497, P<0.05), and the radiation dose of group B was markedly decreased, compared with group A. In conclusion, the present study demonstrated that prospectively ECG-gated scanning of dual-source CT is an effective method of examination for dose reduction in children with congenital heart disease without impairment of image quality, which suggests that this protocol may be suitable for future application and dissemination.

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Comprehensive low-dose imaging of carotid and coronary arteries with a single-injection dual-source CT angiography protocol

Cited by 10 publications

References 46 publications

Ultra‑low dose one‑step CT angiography for coronary, carotid and cerebral arteries using 128‑slice dual‑source CT: A feasibility study

Ultra‑low dose one‑step CT angiography for coronary, carotid and cerebral arteries using 128‑slice dual‑source CT: A feasibility study

Imaging of the vulnerable carotid plaque

Application of low-dose dual-source computed tomography angiography in children with complex congenital heart disease

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