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

Hedgire, Sandeep; Baliyan, Vinit; Ghoshhajra, Brian B.; Kalra, Mannudeep K.

doi:10.1117/1.jmi.4.3.031211

Cited by 21 publications

(19 citation statements)

References 89 publications

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“… 34) Since then, innovations such as prospective ECG gating, high-pitch helical scanning, ECG-controlled tube-current modulation, wider detector coverage, and iterative reconstruction techniques have dramatically lowered the radiation dose. 35) 36) Today, sub-millisievert scans are possible in many children. 37) Jin et al 38) compared the image quality and radiation doses of retrospective and prospective ECG-gated, dual-source CT imaging in pediatric patients with congenital heart diseases.…”

Section: Protocolsmentioning

confidence: 99%

Role of Computed Tomography in Pre- and Postoperative Evaluation of a Double-Outlet Right Ventricle

Kumar

Bhatia²

2021

J Cardiovasc Imaging

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Double-outlet right ventricle (DORV) is a type of ventriculoarterial connection in which both great arteries arise entirely or predominantly from the right ventricle. The morphology of DORV is characterized by a ventricular septal defect (location and relationship with the semilunar valve); bilateral coni and aortomitral continuity; the presence or absence of outflow tract obstruction; tricuspid-pulmonary annular distance; and associated cardiac anomalies. The surgical approach varies with the type of DORV and is based on multiple variables. Computed tomography (CT) is a robust diagnostic tool for the preoperative and postoperative assessment of DORV. Unlike echocardiography and magnetic resonance imaging (MRI), CT imaging is not limited by small acoustic window, need for anaesthesia and can be used in patients with metallic implants. Current generations CT scanners with high spatial and temporal resolution, wide detectors, high-pitch scanning mode, dose-reduction algorithms, and advanced three-dimensional post-processing tools provide a low-risk, high-quality alternative to diagnostic cardiac catheterization or MRI, and have been increasingly utilized in nearly every type of congenital heart defect, including DORV.

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Section: Protocolsmentioning

confidence: 99%

Role of Computed Tomography in Pre- and Postoperative Evaluation of a Double-Outlet Right Ventricle

Kumar

Bhatia²

2021

J Cardiovasc Imaging

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“…Moreover, these V/Q SPECT images can be fused with CTPA images to provide further structural and functional information (35). ECG-gated CT can provide detailed visualization of segmental and subsegmental vessels, lung parenchyma and RV myocardial size and morphology and allows quantitative assessment of RV function with lower radiation dose than conventional CTPA (38,39). It can also be used to assess for significant coronary artery disease, which needs to be excluded when working up patients for PEA (38).…”

Section: Ctpamentioning

confidence: 99%

Chronic thromboembolic pulmonary hypertension: diagnosis, operability assessment and patient selection for pulmonary endarterectomy

Verbelen¹,

Godinas²,

Maleux³

et al. 2022

Ann Cardiothorac Surg

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“…This is commonly achieved on modern scanners using retrospective gating with continuous data acquisition through the cardiac cycle with considerably lower radiation dose than historical scanners. 7,[36][37][38] ECG-gated CT can also be used to visualize the coronary arteries and therefore assess for significant coronary artery disease, which needs to be excluded when workingup patients for PEA. 35 The accuracy of ECG-gated CT angiography in assessing pulmonary arteries for signs of CTEPH has been reported to be superior to contrast-enhanced magnetic resonance angiography and DSA.…”

Section: Electrocardiogram-gated Ctmentioning

confidence: 99%

Optimizing the diagnosis and assessment of chronic thromboembolic pulmonary hypertension with advancing imaging modalities

Kligerman

Hsiao

2021

Pulm. circ.

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Imaging is key to nearly all aspects of chronic thromboembolic pulmonary hypertension (CTEPH) including management for screening, assessing eligibility for pulmonary endarterectomy, and post-operative follow-up. While ventilation/perfusion (V/Q) scintigraphy, the gold standard technique for CTEPH screening, can have excellent sensitivity, it can be confounded by other etiologies of pulmonary malperfusion, and does not provide structural information to guide operability assessment. Conventional computed tomography pulmonary angiography (CTPA) has high specificity, though findings of CTEPH can be visually subtle and unrecognized. In addition, CTPA can provide morphologic information to aid in pre-operative workup and assessment of other structural abnormalities. Advances in computed tomography (CT) imaging techniques, including dual-energy CT (DECT) and spectral-detector CT allow for improved sensitivity and specificity in detecting CTEPH, comparable to that of V/Q scans. Furthermore, these advanced CT techniques, compared with conventional CT, provide additional physiologic data from perfused blood volume maps and improved resolution to better visualize distal CTEPH, an important consideration for balloon pulmonary angioplasty for inoperable patients. Electrocardiogram (ECG)-synchronized techniques in ECG-gated CT can also show further information regarding right ventricular function and structure. While the standard of care in the workup of CTEPH includes a V/Q scan, CTPA, direct catheter angiography, echocardiogram, and coronary angiogram, in the future a ECG-gated DECT angiography scan may enable a âone-stopâ imaging study to guide diagnosis, operability assessment, and treatment decisions with less radiation exposure and cost than traditional CTEPH imaging modalities.

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

Cited by 21 publications

References 89 publications

Role of Computed Tomography in Pre- and Postoperative Evaluation of a Double-Outlet Right Ventricle

Role of Computed Tomography in Pre- and Postoperative Evaluation of a Double-Outlet Right Ventricle

Chronic thromboembolic pulmonary hypertension: diagnosis, operability assessment and patient selection for pulmonary endarterectomy

Optimizing the diagnosis and assessment of chronic thromboembolic pulmonary hypertension with advancing imaging modalities

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