Improving Image Quality of Coronary Computed Tomography Angiography Using Patient Weight and Height-Dependent Scan Trigger Threshold

Objective.To compare the image quality of coronary computed tomography angiography (CCTA) acquired under two conditions: 75% fixed as the acquisition window center (Group 75%) and the diagnostic phase for calcium scoring scan as the center (CS; Group CS).Methods.320-row cardiac CT with a minimal acquisition window (scanned using “Target CTA” mode) was performed on 81 patients. In Group 75% (n= 40), CS was obtained and reconstructed at 75% and the center of the CCTA acquisition window was set at 75%. In Group CS (n= 41), CS was obtained at 75% and the diagnostic phase showing minimal artifacts was applied as the center of the CCTA acquisition window. Image quality was evaluated using a four-point scale (4-excellent) and the mean scores were compared between groups.Results.The CCTA scan diagnostic phase occurred significantly earlier in CS (75.7 ± 3.2% vs. 73.6 ± 4.5% for Groups 75% and CS, resp.,p= 0.013). The mean Group CS image quality score (3.58 ± 0.63) was also higher than that for Group 75% (3.19 ± 0.66,p< 0.0001).Conclusions.The image quality of CCTA in Target CTA mode was significantly better when the center of acquisition window is adjusted using CS.

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Radiation Dose and Image Quality of a High-Pitch Prospective Spiral First Approach in Coronary Computed Tomography Angiography (CCTA)

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8100119 ◽

2021 ◽

Vol 8 (10) ◽

pp. 119

Author(s):

Tom Finck ◽

Konstantin Klambauer ◽

Eva Hendrich ◽

Albrecht Will ◽

Stefan Martinoff ◽

...

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Radiation Exposure ◽

Computed Tomography Angiography ◽

Coronary Computed Tomography Angiography ◽

Diagnostic Yield ◽

Diagnostic Image Quality ◽

High Pitch ◽

Coronary Computed Tomography

Objective: To investigate a high-pitch spiral first (HPSF) approach for coronary computed tomography angiography (CCTA) in an unselected patient cohort and compare diagnostic yield and radiation exposure to CCTAs acquired via conventional, non-high-pitch spiral first (NHPSF) scan regimes. Materials and Methods: All consecutive patients from 1 January 2015 to 31 December 2017 were included. Two investigation protocols (HPSF/NHPSF) were used with the aim to achieve diagnostic image quality of all coronary segments. Low-pitch secondary scans followed the initial examination if image quality was unsatisfactory. Dosage and image quality were compared between both regimes. Results: 1410 patients were subject to a HPSF and 236 patients to a NHPSF approach. While the HPSF approach led to a higher fraction of re-scans (35% vs. 11%, p < 0.001), the fraction of aggregate scans that remained non-diagnostic after considering the initial and secondary scan was comparably low for the HPSF and NHPSF approach (0.78 vs. 0%, p = 0.18). Aggregate radiation exposure in the HPSF protocol was significantly lower (1.12 mSv (IQR: 0.73, 2.10) vs. 3.96 mSv (IQR: 2.23, 8.33) p < 0.001). Conclusions: In spite of a higher number of re-scans, a HPSF approach leads to a reduction in overall radiation exposure with diagnostic yields similar to a NHPSF approach.

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