Abstract 2598: Radiation Exposure, Procedure Time And Contrast Load In Patients Referred For Coronary Angiography: Head-to-head Comparison Of Dual Source Ct With Conventional Coronary Angiography.

Introduction and aim: Dual Source CT (DSCT) scanners, with an increased temporal resolution (83 ms), are becoming widely available. To evaluate the current potential of this scanner in the clinical arena, we performed a head-to-head comparison with conventional coronary angiography (CCA) taking into account the following parameters: radiation exposure, procedure time and contrast load. Methods: During a one-year period (april 2006 to march 2007) we compared a consecutive patient group who underwent DSCT (318 patients, 222 male, mean age 68±11 years) and CCA (352 patients, 258 male, mean age 61±12) respectively. Patients with previous bypass surgery were excluded. In DSCT, the volume of iodinated contrast material was adapted to the scan time. A contrast bolus was injected in an antecubital vein at a flow rate of 5.0 ml/s followed by a saline chaser of 40 ml at 5.0 ml/s. Each tube provided 412 mAs/rot (maximum), and full X-ray tube current was given during 25–70% of the RR-interval. Exposure data were collected using the x-ray dosimetrical reports from DSCT and CCA. Results: The mean procedure time using DSCT and CCA was 16.1±4.7 min and 44.1±25.5 min (p<0.001), respectively. The mean contrast load in DSCT and CCA was 77.9±7.6 ml and 175.3±4.3ml (p<0.001), respectively. The overall radiation exposure for DSCT and CCA was calculated as 15.3±4.0 mSv and 5.7±4.3 mSv, respectively. Radiation exposure with DSCT was significantly lower (p<0.001) in patients with a heart rate of >70 bpm (12.9±3.1 mSv ) as compared with patients with heart rates <70 bpm (16.4±3.8 mSv). Conclusion: In today’s practice currently available DSCT scanners perform favorably as compared with CCA, considering procedure time and patient contrast load. Radiation exposure with DSCT remains higher but should not be considered a major disadvantage taking into account the relatively old age group that generally undergoes coronary angiography and the major benefit of not being exposed to the risks of an invasive procedure.

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Intravenous Contrast Material Administration at High-pitch Dual-source CT Coronary Angiography: Bolus-tracking Technique with Shortened Time of Respiratory Instruction Versus Test Bolus Technique

Chinese Medical Sciences Journal ◽

10.1016/s1001-9294(13)60006-1 ◽

2012 ◽

Vol 27 (4) ◽

pp. 225-231 ◽

Cited By ~ 3

Author(s):

Kai Sun ◽

Guo-rong Liu ◽

Yue-chun Li ◽

Rui-juan Han ◽

Li-fang Cui ◽

...

Keyword(s):

Coronary Angiography ◽

Contrast Material ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

High Pitch ◽

Intravenous Contrast ◽

Dual Source ◽

Test Bolus ◽

Test Bolus Technique ◽

Versus Test

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An individualized contrast material injection protocol with respect to patient-related factors for dual-source CT coronary angiography

Clinical Radiology ◽

10.1016/j.crad.2013.09.018 ◽

2014 ◽

Vol 69 (2) ◽

pp. e86-e92 ◽

Cited By ~ 6

Author(s):

X. Zhu ◽

Y. Zhu ◽

H. Xu ◽

Y. Wan ◽

K.S. Choo ◽

...

Keyword(s):

Coronary Angiography ◽

Contrast Material ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

Related Factors ◽

Dual Source ◽

Injection Protocol

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Image Quality and Radiation Exposure Using Different Low-Dose Scan Protocols in Dual-Source CT Coronary Angiography: Randomized Study

Radiology ◽

10.1148/radiol.11110606 ◽

2011 ◽

Vol 261 (3) ◽

pp. 779-786 ◽

Cited By ~ 59

Author(s):

Lisan A. Neefjes ◽

Anoeshka S. Dharampal ◽

Alexia Rossi ◽

Koen Nieman ◽

Annick C. Weustink ◽

...

Keyword(s):

Image Quality ◽

Coronary Angiography ◽

Radiation Exposure ◽

Low Dose ◽

Randomized Study ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

Dual Source

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Comparison of Myocardial Bridging by Dual-Source CT With Conventional Coronary Angiography

Circulation Journal ◽

10.1253/circj.72.1079 ◽

2008 ◽

Vol 72 (7) ◽

pp. 1079-1085 ◽

Cited By ~ 23

Author(s):

Guang-Ming Lu ◽

Long-Jiang Zhang ◽

Hua Guo ◽

Wei Huang ◽

Reto D. Merges

Keyword(s):

Coronary Angiography ◽

Conventional Coronary Angiography ◽

Dual Source Ct ◽

Myocardial Bridging ◽

Dual Source

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Dual-source CT coronary angiography involving injection protocol with iodine load tailored to patient body weight and body mass index: Estimation of optimal contrast material dose

Acta Radiologica ◽

10.1258/ar.2012.120362 ◽

2013 ◽

Vol 54 (2) ◽

pp. 149-155 ◽

Cited By ~ 9

Author(s):

Xiaomei Zhu ◽

Yinsu Zhu ◽

Hai Xu ◽

Guanyu Yang ◽

Lijun Tang ◽

...

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Coronary Angiography ◽

Body Mass ◽

Contrast Material ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

Dual Source ◽

Injection Protocol ◽

Index Estimation

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Efficacy and Comparison of 256-Slice Dual Source CT Angiography with Catheter Coronary Angiography at Different Heart Rates without using Beta Blockers

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/42906.13866 ◽

2020 ◽

Author(s):

Neeraj Jain ◽

Udit Chauhan ◽

Lalendra Upreti ◽

Sunil Kumar Puri

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Ct Angiography ◽

Predictive Value ◽

Beta Blockers ◽

Dual Source Ct ◽

Group I ◽

Dual Source ◽

The Mean ◽

Sensitivity Specificity

Introduction: Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality in India as well as worldwide. CT angiography is an excellent imaging modality for evaluation of CAD. Previous studies with 64 or lesser slice CT scanner have failed to show consistent and optimal Image Quality (IQ) at Heart Rate (HR) more than 70 bpm and required beta blockers. Aim: To evaluate the diagnostic accuracy of 256-slice Dual Source CT Angiography (DSCTA) in comparison with Catheter Coronary Angiography (CCA) in evaluation of Coronary Arteries (CA) in patients with clinical suspicion of CAD and to study its effectiveness at higher HR without using beta blockers. Materials and Methods: This cross-sectional study was conducted on patients (n=46) with suspected CAD using ECG triggered 256-slice Dual Source Computed Tomography (DSCT) over a period of nine months. Patients were sub grouped according to HR (Group I: 50-70 (18 patients), Group II: 71-90 (24 patients) and Group III ≥91 (8 patients). A total of 48% patients had HR of 71-90 bpm while 16% had HR ≥91 bpm. Scan protocols included prospective ECG triggering (HR <75 bpm) and retrospective spiral scan protocols (HR >75 bpm). CA segments were analysed for IQ on a 4 point scale (1 is worst while 4 is best) by two independent readers who were blinded to the patient details. Accuracy to detect significant luminal stenosis was correlated with CCA (gold standard). Statistical significance of the study was established by Chi-square test (p<0.05). Results: The mean HR and Standard Deviation (SD) in the study was 76±13.7 bpm (range 54-105). Out of 675 CA segments analysed mean IQ score and SD in medium (71-90 bpm) and high HR (≥91 bpm) groups were 3.55±0.62 and 3.25±0.62 which were comparable to IQ in low HR group (3.84±0.36). This indicates excellent IQ even at HR of ≥91 bpm (p<0.05). The mean IQ score of entire study group was 3.88±0.33. Right Coronary artery (RCA) showed best IQ score in each category followed by Left Anterior Descending (LAD) and Left Circumflex (LCX). Inter-observer agreement analysis was performed using Kappa analysis to determine agreement between DSCTA readers. Kappa values for low, medium and high HR groups were 0.866, 0.842 and 0.836. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy for detecting significant stenosis in medium and high HR groups were 95%, 99.2%, 98.4%, 98.7%, 98.9% and 94.3%, 98.9%, 96.9%, 97.6%, 97.9%, respectively. Conclusion: 256-slice DSCTA is a reliable technique with high sensitivity, specificity, PPV and NPV for assessment of CA even at higher HR without using beta blockers.

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