Wide-detector axial CT versus 4 cm detector helical CT for transcatheter aortic valve replacement: iodine dose, radiation, and image quality

Shuman, William P.; Green, Doug E.; Busey, Janet M.; Ramos, Mario; Branch, Kelley R.; Koprowicz, Kent M; Kanal, Kalpana M.

doi:10.1016/j.clinimag.2016.08.002

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…In this study, we also confirmed that the image quality of the ECG-gated aortic root CTA is significantly increased when using a second generation 320-row CT in comparison to 64-row CT. This appears consistent as the second generation 320-row CT prevents stair-step or misalignment artifacts since it uses a one-beat volume acquisition [ 26 – 28 ]. More interestingly, as high quality images are mandatory for better planning of vascular access routes, one of the concern was whether lowering the dose of CM would affect the quality of the aorto-ilio-femoral CTA.…”

Section: Discussionsupporting

confidence: 58%

320-row CT transcatheter aortic valve replacement planning with a single reduced contrast media bolus injection

et al. 2018

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ObjectiveTo reduce the iodine load required for CT Transcatheter Aortic Valve Replacement (TAVR) planning on a 320-row scanner by acquiring the two CT TAVR steps (ECG-gated aortic root CTA and non-gated aorto-ilio-femoral CTA) within a single contrast media bolus injection.Methods50 consecutive patients (82.6±6.9 years; 56% female) were prospectively enrolled and underwent a TAVR planning using a 320-row CT, with ECG-gated aortic root CTA immediately followed by a non-gated aorto-iliac acquisition, all within a single bolus of 40-70mL of Iohexol 350mgI/mL. The Iodine load, image quality, SNR, CNR and radiation dose were compared using a Mann-Whitney test to that of 24 consecutive patients (84.3±4.8 years, 58% female) previously imaged on a 64-row scanner with a conventional two-step protocol.ResultsIodine load was reduced by 44%. All examinations were of diagnostic quality, with improvement of the aortic root CTA image quality (4.9±0.3 versus 4.6±0.5, p<0.01) and a non-significant decrease of the aorto-iliac CTA image quality (4.7±0.6 versus 4.9±0.3, p = 0.07). SNR and CNR were significantly improved in the aortic root CTA (14.0±5.3 and 10.4±4.5 versus 10.3±4.2 and 6.8±3.3, p<0.01 for both) and non-significantly higher in the aorto-iliac CTA (16.5±8.0 and 14.1±7.9 versus 14.7±5.5 and 12.5±5.0, p = 0.42 and p = 0.66). Total radiation dose was reduced by 32%.Conclusion320-row CT scanner enables a 44% reduction of iodine load in TAVR planning, while maintaining excellent aorto-ilio-femoral arterial enhancement and lowering radiation dose.

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Section: Discussionsupporting

confidence: 58%

320-row CT transcatheter aortic valve replacement planning with a single reduced contrast media bolus injection

et al. 2018

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“…In the present study, we found that the radiation dose for axial scan CT-guided lung biopsy was lower than that of helical scan CT-guided lung biopsy. Here, we note that other authors have explored the two protocols for transcatheter aortic valve replacement (TAVR) planning CT. One study reported that the axial scan mode yields lower radiation and equivalent image quality (16). In this context, we remark that the helical CT scanner was conceptualized in the 1980s to increase longitudinal scanning via the use of a continuous patient table feed (17).…”

Section: Discussionmentioning

confidence: 99%

Ultra-low-dose CT-guided lung biopsy in clinic: radiation dose, accuracy, image quality, and complication rate

Liang

Guo

et al. 2020

Acta Radiol

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Background Computed tomography (CT)-guided percutaneous lung biopsy is usually performed by helical scanning. However, there are no studies on radiation dose, diagnostic accuracy, image quality, and complications based on axial scan mode. Purpose To determine radiation dose, accuracy, image quality, and complication rate following an ultra-low-dose (ULD) protocol for CT-guided lung biopsy in clinic. Material and Methods A total of 105 patients were enrolled to receive CT-guided lung biopsy. The use of an ULD protocol (axial scan) for CT-guided biopsy was initiated. Patients were randomly assigned to axial mode (Group A) and conventional helical mode (Group B) CT groups. 64-slice CT was performed for CT-guided pulmonary biopsy with an 18-G coaxial cutting biopsy needle. The radiation dose, accuracy, image quality, and complication rate were measured. Results Ninety-seven patients were selected for the final phase of the study. There was no significant difference between the two groups for pulmonary nodule characteristics ( P > 0.05). The mean effective dose in group A (0.077 ± 0.010 mSv) was significantly reduced relative to group B (0.653 ± 0.177 mSv, P < 0.001). There was no significant difference in accuracy, image quality, and complication rate ( P > 0.050) between the two modes. Conclusion An ULD protocol for CT-guided lung nodule biopsy yields a reduction in the radiation dose without significant change in the accuracy, image quality, and complication rate relative to the conventional helical mode scan.

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“…Many authors have suggested various acquisition protocols for TAVI to reduce the contrast material volume https://doi.org/10.3348/kjr.2019.0327 kjronline.org and radiation dose using the wide-detector CT scanner (73)(74)(75), and the suggested methods could be roughly divided into two types: 1) axial ECG-gated volume acquisition for the aortic root and heart followed by ungated helical acquisition for the abdomen and pelvis (82,83) and 2) axial ECG-gated volume acquisition for the aortic root and heart followed by three or four ungated volume acquisitions for the abdomen and pelvis (84). According to previous studies, wide-detector CT scanners enable 30-44% reduction in the iodine load and 32-48% reduction in the radiation dose in TAVI planning, while maintaining or providing better image quality than that of the conventional protocol using 64-detector-row CT scanners (82,84).…”

Section: Transcatheter Aortic Valve Implantation Evaluationmentioning

confidence: 99%

Clinical Applications of Wide-Detector CT Scanners for Cardiothoracic Imaging: An Update

Kang

2019

Korean J Radiol

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Technical developments in multidetector computed tomography (CT) have increased the number of detector rows on the z-axis, and 16-cm wide-area-coverage CT scanners have enabled volumetric scanning of the entire heart. Beyond coronary arterial imaging, such innovations offer several advantages during clinical imaging in the cardiothoracic area. The wide-detector CT scanner markedly reduces the image acquisition time to less than 1 second for coronary CT angiography, thereby decreasing the volume of contrast material and radiation dose required for the examination. It also eliminates stair-step artifacts, allowing robust improvements in myocardial function and perfusion imaging. Additionally, new imaging techniques for the cardiothoracic area, including subtraction imaging and free-breathing scans, have been developed and further improved by using the wide-detector CT scanner. This article investigates the technical developments in wide-detector CT scanners, summarizes their clinical applications in the cardiothoracic area, and provides a review of the recent literature.

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Wide-detector axial CT versus 4 cm detector helical CT for transcatheter aortic valve replacement: iodine dose, radiation, and image quality

Cited by 5 publications

References 9 publications

320-row CT transcatheter aortic valve replacement planning with a single reduced contrast media bolus injection

320-row CT transcatheter aortic valve replacement planning with a single reduced contrast media bolus injection

Ultra-low-dose CT-guided lung biopsy in clinic: radiation dose, accuracy, image quality, and complication rate

Clinical Applications of Wide-Detector CT Scanners for Cardiothoracic Imaging: An Update

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