Radiation dose and diagnostic accuracy of high-pitch dual-source coronary angiography in the evaluation of coronary artery stenoses

Abstract

Prospectively ECG-triggered high-pitch spiral mode coronary CTA provides high image quality and diagnostic accuracy, with very low radiation dose for evaluation and exclusion of coronary artery stenoses.

Diagnostic performance of 256-row detector coronary CT angiography in patients with high heart rates within a single cardiac cycle: a preliminary study

“…Impaired image quality due to high HR, and high radiation dose are still recognized as limitations to CCTA [2,12,19]. The non-proportional shortening of systole and diastole in patients with high HR is well known, with the length of diastole reducing more than that of systole [20].…”

“…Coronary artery disease (CAD) is the leading cause of morbidity and mortality in both developed countries and developing countries [1][2][3]. In the past decade, coronary computed tomography angiography (CCTA) has been established as an effective modality for the anatomical evaluation of CAD.…”

Recent advances in cardiac computed tomography dose reduction strategies: a review of scientific evidence and technical developments

“…66,67 High-pitch helical (HPH) acquisition mode with fast table speed and prospective ECG triggering enables coverage of the entire heart within one cardiac cycle. Several studies on HPH mode for CCTA in pediatric and adult populations 16,63,[68][69][70] have reported good diagnostic quality and consistently low mean radiation dose (0.8 to 1.3 mSv) ( Table 2). The HPH is particularly advantageous in children or young adults for assessment of coronary artery anomalies and anatomic assessment in patients with congenital heart disease (when information regarding cardiac function is not needed).…”

“…In particular, HPH can help avoid need for sedation or anesthesia in young children due to its rapidity. Important limitations of HPH mode include inconsistent diagnostic quality in patients with increased heart rates, 16,68 motion artifacts and nonapplicability of retrospective reconstruction, and functional assessment of the heart. 71 To mitigate the effects of motion on evaluation of coronary artery evaluation, a prior study has recommended use of subsequent acquisitions in two different cardiac cycles.…”

“…[8][9][10][11] Subsequent technologic evolution in both hardware and software CT technologies has helped lead a decreasing trend in mean radiation dose from cardiac CT. 12 Several studies have demonstrated that the radiation dose from cardiac CT angiography (CCTA) can be reduced to lower than invasive catheter angiography with the use of techniques, such as prospective triggering, low tube potential technique, automatic exposure control (AEC), iterative reconstructive techniques, and so on. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Conversely, despite the abundance of radiation dose-reduction strategies, several studies have reported a high variability in the radiation doses from cardiac CT. 11,[28][29][30] In an international, multicenter study, Hausleiter et al 11 reported that median doses from CCTA varied substantially among 21 participating institutions' different CT systems, and that radiation reduction strategies were not adequately utilized.…”