Radiation Dose in a “Triple Rule-Out” Coronary CT Angiography Protocol of Emergency Department Patients Using 64-MDCT: The Impact of ECG-Based Tube Current Modulation on Age, Sex, and Body Mass Index

Takakuwa, Kevin M.; Halpern, Ethan J.; Gingold, Eric L.; Levin, David C.; Shofer, Frances S.

doi:10.2214/ajr.08.1758

Cited by 83 publications

(33 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[20][21][22] These results also extend previously described radiation dose observed in clinical coronary CTA practice, the effectiveness of dose reduction techniques, and preserved image quality. 14,16,[23][24][25] Most importantly, these results demonstrate the sustained effect of this intervention >3 years across a variety of centers providing real world clinical coronary CTA services.…”

Section: Discussionmentioning

confidence: 69%

Progressive Radiation Dose Reduction From Coronary Computed Tomography Angiography in a Statewide Collaborative Quality Improvement Program

Chinnaiyan

Boura

DePetris

et al. 2013

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

The objectives of the present study were to determine whether these reduced doses would be sustained during longterm follow-up, and if advancing CT technology and continued educational interventions would lead to progressive dose reduction over time.Background-A best-practice intervention previously demonstrated significant dose reduction over a period of one year.We sought to evaluate whether this reduction would be incremental and sustained by promoting new scanner technology in the context of an ongoing quality improvement program during a 3-year period in a statewide registry of coronary computed tomography angiography.

show abstract

Section: Discussionmentioning

confidence: 69%

Progressive Radiation Dose Reduction From Coronary Computed Tomography Angiography in a Statewide Collaborative Quality Improvement Program

Chinnaiyan

Boura

DePetris

et al. 2013

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

show abstract

“…Many studies emphasized that the high-dose radiation exposure is due to long scanning length. [31][32][33][34] A meta-analysis published in 2013 highlighted the radiation aspect of the TRO-CT. Ayaram et al (2013) studied radiation exposure in 2,307 patients, of which 377 were included in the triple-rule-out CT group and 1,930 in the control group. A statistically significant difference was observed between the two groups, patients assessed with TRO-CT being exposed to a significantly higher dose of ionising radiation.…”

Section: Which Are the Eligible Patients For The Triple-rule-out Ct Pmentioning

confidence: 99%

Clinical update. Computed Tomography — an Emerging Tool for Triple Rule-Out in the Emergency Department. A Review

Dobra¹,

Bordi²,

Nyulas

et al. 2017

Journal of Cardiovascular Emergencies

View full text Add to dashboard Cite

New imaging tools have been developed in recent years to rapidly and accurately diagnose life-threatening diseases associated with high mortality rates, such as acute coronary syndromes, acute aortic dissection, or pulmonary embolism. The concept of using computed tomographic (CT) assessment in emergency settings is based on the possibility of excluding multiple acute pathologies within one scan. It can be used for patients complaining of acute chest pain of unclear etiology with the possible association of acute coronary dissection or pulmonary embolism, but only a low to moderate risk of developing an acute coronary syndrome. One of the benefits of this protocol is the possibility of decreasing the number of patients who are hospitalized for further investigations. The technique also allows the rapid triage of patients and the safe discharge of those who show negative results. The aim of this review is to summarize the current medical literature regarding the potential use of CT for the triple rule-out (TRO) of coronary etiologies.

show abstract

“…Hierbei fließt der maximale Röhren-strom nur in den in aller Regel verwendeten diastolischen Anteilen der Herzphase, während in den systolischen Anteilen der Röhrenstrom deutlich reduziert wird. Für ein TRO-Protokoll konnte allein durch die Verwendung der Röhrenstrom-modulation die Strahlendosis um mehr als 50% reduziert werden [28]. Beim prospektiven "EKG-Gating" findet der Spiral-Scan nur während der Diastole statt.…”

Section: Prinzipunclassified

“…Beim prospektiven "EKG-Gating" findet der Spiral-Scan nur während der Diastole statt. Für das prospektive Gating konnten ähn-liche Dosiseinsparungen wie für die Nutzung der Röhrenstrommodulation gezeigt werden, die damit deutlich unter 10 mSv liegen [24,28].…”

Section: Prinzipunclassified

„Triple-rule-out“-Computertomographie in der Notaufnahme

Stoevesandt

Buerke

2011

Med Klin

View full text Add to dashboard Cite

In the emergency department patients with chest pain play an important role because the underlying and concealed diseases can be life-threatening. The complaints are often nonspecific and patients also have different risk profiles. In patients in the emergency department with nonspecific chest pain a"1-stop strategy" for elucidation of the three main organs lung, hear and aorta with the 4 main differential diagnoses (aortic dissection, ruptured aortic aneurysm, pulmonary embolism and coronary heart disease) is desirable. Technical advances in computed tomography (CT) in recent years make this approach technically possible. In modern emergency departments CT equipment is becoming more and more common in order to rapidly examine trauma patients. A meaningful patient selection and preparation are, however, necessary to avoid unnecessary exposure of patients to contrast media and radiation. In this way it is possible to reduce the rate of overlooked diseases or false diagnoses.

show abstract

Radiation Dose in a “Triple Rule-Out” Coronary CT Angiography Protocol of Emergency Department Patients Using 64-MDCT: The Impact of ECG-Based Tube Current Modulation on Age, Sex, and Body Mass Index

Abstract: The overall effective radiation dose for triple rule-out coronary CTA was reduced by more than 50% with ECG-based tube current modulation without loss of image quality. Tube current modulation should be used for triple rule-out coronary CTA examinations whenever possible.

Cited by 83 publications

References 31 publications

Progressive Radiation Dose Reduction From Coronary Computed Tomography Angiography in a Statewide Collaborative Quality Improvement Program

Progressive Radiation Dose Reduction From Coronary Computed Tomography Angiography in a Statewide Collaborative Quality Improvement Program

Clinical update. Computed Tomography — an Emerging Tool for Triple Rule-Out in the Emergency Department. A Review

„Triple-rule-out“-Computertomographie in der Notaufnahme

Contact Info

Product

Resources

About