Radiation dose of CT coronary angiography in clinical practice: Objective evaluation of strategies for dose optimization

Yerramasu, Ajay; Venuraju, Shreenidhi; Atwal, Satvir; Goodman, Dennis; Lipkin, David; Lahiri, Avijit

doi:10.1016/j.ejrad.2011.02.040

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…Recent cardiac CT angiographic imaging strategies have focused on radiation reduction techniques that do not compromise IQ. Techniques including automated exposure control, minimizing longitudinal scan range, and electrocardiographically controlled tube modulation can be routinely implemented in nearly all patients (19,21). The use of reduced tube voltage has been shown to significantly reduce effective dose but is appropriate only in patients with small body habitus, because IQ may be adversely affected in overweight and obese patients (22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography

et al. 2012

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“…All scans were acquired using a dual source computed tomography scanner (Somatom Definition, Forchheim, Germany) with a maximum load capacity of 220 kg. The scan protocol consisted of: (1) topogram; (2) prospectively gated, non-enhanced scan to calculate CAC score according to standard protocol using the TeraRecon (Foster City, CA, USA) workstation [11]; (3) test bolus scan to determine the circulation time; and (4) contrast-enhanced coronary angiogram.…”

Section: Methodsmentioning

confidence: 99%

“…Images were then transferred to a dedicated workstation (Leonardo, Siemens, Forchheim, Germany). Axial slices, multiplanar reconstructions and maximum intensity projections were used to evaluate the patency of coronary arteries [11].…”

Section: Methodsmentioning

confidence: 99%

Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Venuraju

Lahiri

Jeevarethinam

et al. 2019

Cardiovasc Diabetol

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Background Evidence from imaging studies suggests a high prevalence of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). However, there are no criteria for initiating screening for CAD in this population. The current study investigated whether clinical and demographic characteristics can be used to predict significant CAD in patients with T2DM. Methods Computed tomography coronary angiography (CTCA) and laboratory assessments were performed in 259 patients diagnosed with T2DM attending clinics in Northwest London, UK. Coronary artery calcium (CAC) was calculated during CTCA. Significant plaque was defined as one causing more than 50% luminal stenosis. Associations between groups and variables were evaluated using Student’s t test, Chi-square tests and univariate and multivariate regression analysis. P < 0.05 was considered statistically significant. Results Among patients with a median duration of T2DM of 13 years and a mean age of 62.0 years, median CAC score was 105.91 Agatston Units. In a multivariate analyses, duration of diabetes, CAC score and the presence and number of coronary artery plaques and presence of significant plaque were significant predictors of cardiovascular adverse events. Systolic blood pressure (SBP) had borderline significance as a predictor of cardiovascular events (p = 0.05). In a receiver operating characteristic curve (ROC) analysis, duration of diabetes of > 10.5 years predicted significant CAD (sensitivity, 75.3%; specificity 48.2%). Area under the ROC curve was 0.67 when combining duration of T2DM > 10.5 years and SBP of > 139 mm Hg. Adverse cardiovascular events after a median follow-up of 22.8 months were also significantly higher in those with duration of T2DM > 10.5 years and SBP > 140 mm Hg (log rank p = 0.02 and 0.009, respectively). Conclusions Routine screening for CAD using CTCA should be considered for patients with a diagnosis of T2DM for > 10.5 years and SBP > 140 mm Hg. Trial registration Clinicaltrials.gov identifier: NCT02109835, 10 April 2014 (retrospectively registered)

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“…7 Examples of dose-reduction techniques include prospective ECG-triggering 11 ; automated exposure control 12 ; and a reduction of the Z-axis length. 13 The efficiency of these dose reduction techniques can be restricted by filtered back projection (FBP). In FBP the image reconstructions are based upon ideal assumptions and approximations which can leave the acquired data inaccurate and undersampled, particularly when radiation dose is not sufficient.…”

Section: Introductionmentioning

confidence: 99%

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

2016

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a b s t r a c tIntroduction: Coronary computed tomography angiography (CCTA) is a reliable, minimally invasive technique used in the diagnosis and characterisation of coronary artery disease. Within this modality iterative reconstruction has the potential to maintain image quality whilst reducing radiation dose. Methods: A priori search terms and inclusion/exclusion criteria were developed. Results: Three studies were included in the review which analysed a total of 227 participants. As CTDI vol decreased there was no significant change in objective image quality, although some subjective image quality scores decreased. Discussion: The decrease of subjective image quality scores may be explained as a reaction to the difference in image appearance of the iterative reconstruction images; a potential reduction in dynamic range; and the number of scorers used. Conclusion: Iterative reconstruction can be utilized as a tool to significantly reduce patients' exposure to ionising radiation; however there may be implications for radiologists/cardiologist in the interpretation of these images.

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Radiation dose of CT coronary angiography in clinical practice: Objective evaluation of strategies for dose optimization

Cited by 10 publications

References 20 publications

Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography

Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography

Duration of type 2 diabetes mellitus and systolic blood pressure as determinants of severity of coronary stenosis and adverse events in an asymptomatic diabetic population: PROCEED study

Maintaining image quality and reducing dose in prospectively-triggered CT coronary angiography: A systematic review of the use of iterative reconstruction

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