Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography. Comparison with Retrospective Spiral Technique

Monvadi B. Srichai; Ruth P. Lim; Robert Donnino; Lorenzo Mannelli; Rajesh Hiralal; Ryan Avery; Corey Ho; James S. Babb; Jill E. Jacobs

doi:10.1016/j.acra.2012.01.009

Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography. Comparison with Retrospective Spiral Technique

Monvadi B. Srichai^*, Ruth P. Lim, Robert Donnino, Lorenzo Mannelli, Rajesh Hiralal, Ryan Avery, Corey Ho, James S. Babb, Jill E. Jacobs

^*Corresponding author for this work

Radiology

Research output: Contribution to journal › Article

24 Scopus citations

Abstract

Rationale and Objectives: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral cardiac computed tomographic angiography (FLASH-CT) compared to retrospective electrocardiographic gating (RETRO-CT) for coronary artery disease evaluation in a patient population including overweight and obese individuals. Materials and Methods: Seventy patients (24 women; mean age, 60 years) matched for gender, age, body mass index (27.4 ± 5.5 kg/m ²), and calcium score (184 ± 328) underwent cardiac computed tomographic angiography, 35 with FLASH-CT (Definition Flash) and 35 with RETRO-CT (Somatom Definition). Images were reconstructed using standard protocols and least motion phase for RETRO-CT acquisitions. Two independent, blinded readers evaluated the coronary arteries using an 18-segment model, grading IQ on a 5-point, Likert-type scale and coronary stenosis on a 5-point semiquantitative and binary scale. Results: Effective radiation dose (1.50 vs 17.3 mSv, P < .0001) and mean heart rate (58 vs 62 beats/min, P < .05) were significantly lower for FLASH-CT compared to RETRO-CT. Seven hundred forty segments (>1.5 mm) were evaluated. There was no significant difference between FLASH-CT and RETRO-CT scans in overall per-segment IQ (3.11 ± 0.75 vs 3.10 ± 0.82, P = .94). FLASH-CT had noninferior IQ relative to RETRO-CT (95% confidence interval, -0.25 to 0.26). There was no significant difference in interreader variability in diagnosis between FLASH-CT and RETRO-CT for all coronary segments (77.5% vs 78.2%, P = .83). Conclusions: FLASH-CT is an acceptable coronary computed tomographic angiographic method for reducing radiation dose without compromising IQ for a patient population including overweight and obese individuals.

Original language	English (US)
Pages (from-to)	554-561
Number of pages	8
Journal	Academic Radiology
Volume	19
Issue number	5
DOIs	https://doi.org/10.1016/j.acra.2012.01.009
State	Published - May 1 2012

Keywords

Coronary artery disease
Coronary CT angiography
Prospective gating
Radiation dose
Retrospective gating

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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@article{1a9e17a0d52f4ce5a7b44081865c173d,

title = "Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography. Comparison with Retrospective Spiral Technique",

abstract = "Rationale and Objectives: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral cardiac computed tomographic angiography (FLASH-CT) compared to retrospective electrocardiographic gating (RETRO-CT) for coronary artery disease evaluation in a patient population including overweight and obese individuals. Materials and Methods: Seventy patients (24 women; mean age, 60 years) matched for gender, age, body mass index (27.4 ± 5.5 kg/m 2), and calcium score (184 ± 328) underwent cardiac computed tomographic angiography, 35 with FLASH-CT (Definition Flash) and 35 with RETRO-CT (Somatom Definition). Images were reconstructed using standard protocols and least motion phase for RETRO-CT acquisitions. Two independent, blinded readers evaluated the coronary arteries using an 18-segment model, grading IQ on a 5-point, Likert-type scale and coronary stenosis on a 5-point semiquantitative and binary scale. Results: Effective radiation dose (1.50 vs 17.3 mSv, P < .0001) and mean heart rate (58 vs 62 beats/min, P < .05) were significantly lower for FLASH-CT compared to RETRO-CT. Seven hundred forty segments (>1.5 mm) were evaluated. There was no significant difference between FLASH-CT and RETRO-CT scans in overall per-segment IQ (3.11 ± 0.75 vs 3.10 ± 0.82, P = .94). FLASH-CT had noninferior IQ relative to RETRO-CT (95% confidence interval, -0.25 to 0.26). There was no significant difference in interreader variability in diagnosis between FLASH-CT and RETRO-CT for all coronary segments (77.5% vs 78.2%, P = .83). Conclusions: FLASH-CT is an acceptable coronary computed tomographic angiographic method for reducing radiation dose without compromising IQ for a patient population including overweight and obese individuals.",

keywords = "Coronary artery disease, Coronary CT angiography, Prospective gating, Radiation dose, Retrospective gating",

author = "Srichai, {Monvadi B.} and Lim, {Ruth P.} and Robert Donnino and Lorenzo Mannelli and Rajesh Hiralal and Ryan Avery and Corey Ho and Babb, {James S.} and Jacobs, {Jill E.}",

year = "2012",

month = may,

day = "1",

doi = "10.1016/j.acra.2012.01.009",

language = "English (US)",

volume = "19",

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journal = "Academic Radiology",

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Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography. Comparison with Retrospective Spiral Technique. / Srichai, Monvadi B.; Lim, Ruth P.; Donnino, Robert; Mannelli, Lorenzo; Hiralal, Rajesh; Avery, Ryan; Ho, Corey; Babb, James S.; Jacobs, Jill E.

In: Academic Radiology, Vol. 19, No. 5, 01.05.2012, p. 554-561.

Research output: Contribution to journal › Article

TY - JOUR

T1 - Low-dose, Prospective Triggered High-pitch Spiral Coronary Computed Tomography Angiography. Comparison with Retrospective Spiral Technique

AU - Srichai, Monvadi B.

AU - Lim, Ruth P.

AU - Donnino, Robert

AU - Mannelli, Lorenzo

AU - Hiralal, Rajesh

AU - Avery, Ryan

AU - Ho, Corey

AU - Babb, James S.

AU - Jacobs, Jill E.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Rationale and Objectives: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral cardiac computed tomographic angiography (FLASH-CT) compared to retrospective electrocardiographic gating (RETRO-CT) for coronary artery disease evaluation in a patient population including overweight and obese individuals. Materials and Methods: Seventy patients (24 women; mean age, 60 years) matched for gender, age, body mass index (27.4 ± 5.5 kg/m 2), and calcium score (184 ± 328) underwent cardiac computed tomographic angiography, 35 with FLASH-CT (Definition Flash) and 35 with RETRO-CT (Somatom Definition). Images were reconstructed using standard protocols and least motion phase for RETRO-CT acquisitions. Two independent, blinded readers evaluated the coronary arteries using an 18-segment model, grading IQ on a 5-point, Likert-type scale and coronary stenosis on a 5-point semiquantitative and binary scale. Results: Effective radiation dose (1.50 vs 17.3 mSv, P < .0001) and mean heart rate (58 vs 62 beats/min, P < .05) were significantly lower for FLASH-CT compared to RETRO-CT. Seven hundred forty segments (>1.5 mm) were evaluated. There was no significant difference between FLASH-CT and RETRO-CT scans in overall per-segment IQ (3.11 ± 0.75 vs 3.10 ± 0.82, P = .94). FLASH-CT had noninferior IQ relative to RETRO-CT (95% confidence interval, -0.25 to 0.26). There was no significant difference in interreader variability in diagnosis between FLASH-CT and RETRO-CT for all coronary segments (77.5% vs 78.2%, P = .83). Conclusions: FLASH-CT is an acceptable coronary computed tomographic angiographic method for reducing radiation dose without compromising IQ for a patient population including overweight and obese individuals.

AB - Rationale and Objectives: Cardiac computed tomographic angiography algorithms emphasize radiation reduction while maintaining diagnostic image quality (IQ). The aim of this study was to evaluate IQ and interreader variability using prospective electrocardiographically triggered high-pitch spiral cardiac computed tomographic angiography (FLASH-CT) compared to retrospective electrocardiographic gating (RETRO-CT) for coronary artery disease evaluation in a patient population including overweight and obese individuals. Materials and Methods: Seventy patients (24 women; mean age, 60 years) matched for gender, age, body mass index (27.4 ± 5.5 kg/m 2), and calcium score (184 ± 328) underwent cardiac computed tomographic angiography, 35 with FLASH-CT (Definition Flash) and 35 with RETRO-CT (Somatom Definition). Images were reconstructed using standard protocols and least motion phase for RETRO-CT acquisitions. Two independent, blinded readers evaluated the coronary arteries using an 18-segment model, grading IQ on a 5-point, Likert-type scale and coronary stenosis on a 5-point semiquantitative and binary scale. Results: Effective radiation dose (1.50 vs 17.3 mSv, P < .0001) and mean heart rate (58 vs 62 beats/min, P < .05) were significantly lower for FLASH-CT compared to RETRO-CT. Seven hundred forty segments (>1.5 mm) were evaluated. There was no significant difference between FLASH-CT and RETRO-CT scans in overall per-segment IQ (3.11 ± 0.75 vs 3.10 ± 0.82, P = .94). FLASH-CT had noninferior IQ relative to RETRO-CT (95% confidence interval, -0.25 to 0.26). There was no significant difference in interreader variability in diagnosis between FLASH-CT and RETRO-CT for all coronary segments (77.5% vs 78.2%, P = .83). Conclusions: FLASH-CT is an acceptable coronary computed tomographic angiographic method for reducing radiation dose without compromising IQ for a patient population including overweight and obese individuals.

KW - Coronary artery disease

KW - Coronary CT angiography

KW - Prospective gating

KW - Radiation dose

KW - Retrospective gating

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