The value of flat-detector computed tomography during catheterisation of congenital heart disease

Glöckler, Martin; Koch, Andreas; Greim, V.; Shabaiek, Amira; Rüffer, André; Cesnjevar, Robert; Achenbach, Stephan; Dittrich, Sven

doi:10.1007/s00330-011-2214-3

Cited by 26 publications

(33 citation statements)

References 22 publications

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“…The 3D model can be produced from different imaging modalities, such as CT, magnetic resonance, or ultrasound images. In cardiology, its use is limited to radiofrequency‐based atrial fibrillation ablation procedures and to complex rythmological and hemodynamic interventions in congenital heart diseases patients . So far, all of these evaluations are limited to feasibility studies or case reports providing a subjective evaluation of the contributions of this technology.…”

Section: Discussionmentioning

confidence: 99%

Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

Plessis

Fresse

Cahouch

et al. 2016

JAHA

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BackgroundCoronary angiography is more complex in patients with coronary artery bypass grafts (CABG). Image fusion is a new technology that allows the overlay of a computed tomography (CT) three‐dimension (3D) model with fluoroscopic images in real time.Methods and ResultsThis single‐center prospective study included 66 previous CABG patients undergoing coronary and bypass graft angiography. Image fusion coronary angiographies (fusion group, 20 patients) were compared to conventional coronary angiographies (control group, 46 patients). The fusion group included patients for whom a previous chest CT scan with contrast was available. For patients in this group, aorta and CABG were reconstructed in 3D from CT acquisitions and merged in real time with fluoroscopic images. The following parameters were compared: time needed to localize the CABG; procedure duration; air kerma (AK); dose area product (DAP); and volume of contrast media injected. Results are expressed as median. There were no significant differences between the 2 groups in patient demographics and procedure characteristics (access site, number of bypass to be found, and interventional cardiologist's experience). The time to localize CABG was significantly shorter in the fusion group (7.3 versus 12.4 minutes; P=0.002), as well as the procedure duration (20.6 versus 25.6 minutes; P=0.002), AK (610 versus 814 mGy; P=0.02), DAP (4390 versus 5922.5 cGy·cm2; P=0.02), and volume of iodinated contrast media (85 versus 116 cc; P=0.002).Conclusions3D image fusion improves the CABG detection in coronary angiography and reduces the time necessary to localize CABG, total procedure time duration, radiation exposure, and volume of contrast media.

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Section: Discussionmentioning

confidence: 99%

Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

Plessis

Fresse

Cahouch

et al. 2016

JAHA

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“…Despite the scarce information in the literature 5,19,20 , the use of 3D-RA in this context reduces the number of necessary acquisitions and brings the possibility of increasing accuracy in the assessment of patients with defects with a complex anatomy; however, it is not yet well established whether 3D-RA adds information on these defects.…”

Section: Discussionmentioning

confidence: 99%

“…In 2011, Glockler et al 19 evaluated and reported their experience in 62 patients with a median weight of 14.4 Kg undergoing rotational angiography for the assessment of pulmonary arteries, aorta, and cavopulmonary connections. In this study, the images were considered superior to those of conventional angiography in 90.3% of cases and very useful for guiding interventional procedures using overlaying three-dimensional images.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Radiation Dose Between Standard and 3D Angiography in Congenital Heart Disease

Mânica¹,

Borges²,

Medeiros³

et al. 2014

Arquivos Brasileiros De Cardiologia

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Background The use of three-dimensional rotational angiography (3D-RA) to assess patients with congenital heart diseases appears to be a promising technique despite the scarce literature available. Objectives The objective of this study was to describe our initial experience with 3D-RA and to compare its radiation dose to that of standard two-dimensional angiography (2D-SA). Methods Between September 2011 and April 2012, 18 patients underwent simultaneous 3D-RA and 2D-SA during diagnostic cardiac catheterization. Radiation dose was assessed using the dose-area-product (DAP). Results The median patient age and weight were 12.5 years and 47.5 Kg, respectively. The median DAP of each 3D-RA acquisition was 1093µGy.m2 and 190µGy.m2 for each 2D-SA acquisition (p<0.01). In patients weighing more than 45Kg (n=7), this difference was attenuated but still significant (1525 µGy.m2 vs.413µGy.m2, p=0.01). No difference was found between one 3D-RA and three 2D-SA (1525µGy.m2 vs.1238 µGy.m2, p = 0.575) in this population. This difference was significantly higher in patients weighing less than 45Kg (n=9) (713µGy.m2 vs.81µGy.m2, P = 0.008), even when comparing one 3D-RA with three 2D-SA (242µGy.m2, respectively, p<0.008). 3D-RA was extremely useful for the assessment of conduits of univentricular hearts, tortuous branches of the pulmonary artery, and aorta relative to 2D-SA acquisitions. Conclusions The radiation dose of 3D-RA used in our institution was higher than those previously reported in the literature and this difference was more evident in children. This type of assessment is of paramount importance when starting to perform 3D-RA.

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“…This was done in compliance with the International Commission on Radiological Protection 103 guidelines [17]. Radiation dose and the irradiated area were measured in the collimator housing, independent from the patient distance [18]. Out of these system reported doses the radiation dose in μGym²/kg was calculated for the 483 cases and compared between the diagnostic program and the low dose program.…”

Section: Methodsmentioning

confidence: 99%

Rotational Angiography for 3D Roadmapping of Catheter Interventions in Congenital Heart Disease: Comparison of a Diagnostic and a Low Dose Program

Thoenes¹,

Cesnjevar²,

Dittrich³

et al. 2016

OJRad

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Objectives: To compare the image quality, accuracy and effective dose of the default diagnostic program with the low dose program. Methods: The diagnostic and low dose programs of three-dimensional rotational angiography were compared considering their signal to noise ratio, their carrier to noise ratio and their actual radiation dose in μGy·m²/kg. An anthropomorphic phantom underwent both types of scans to evaluate the effective dose. Comparative measurements of vessel diameters were taken in the diagnostic and the low dose program and compared to the angiography as exact basis. The image quality of the scans using the different programs was rated by a specialist physician. Results: The low dose scan does use significantly less radiation and still provides images, which are adequate for 3D navigation of catheter-based interventions. Conclusion: Three-dimensional rotational angiography can be applied with the low dose program and is sufficient for 3D navigation.

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The value of flat-detector computed tomography during catheterisation of congenital heart disease

Abstract: FD-CT provides useful diagnostic information in most of the patients investigated for congenital heart disease. The added radiation exposure and contrast medium volume are reasonable.

Cited by 26 publications

References 22 publications

Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

Value of Image Fusion in Coronary Angiography for the Detection of Coronary Artery Bypass Grafts

A Comparison of Radiation Dose Between Standard and 3D Angiography in Congenital Heart Disease

Rotational Angiography for 3D Roadmapping of Catheter Interventions in Congenital Heart Disease: Comparison of a Diagnostic and a Low Dose Program

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