Stent evaluation by coronary computed tomography angiography: a comparison between Iopamidol-370 and Ioversol-320 hypo-osmolar iodine concentration contrasts

Objective: Qualitative and quantitative image analysis between Iopamidol-370 and Ioversol-320 in stents´ evaluation by coronary computed tomography angiography (CTA). Methods: Sixty-five patients with low-risk stable angina undergoing stent follow-up with coronary CTA were assigned to Iopamidol I-370 (n = 33) or Ioversol I-320 (n = 32) in this prospective, double-blind, non-inferiority, randomized trial. Stent lumen image quality was graded by 5-point Likert Scale. Lumen mean attenuation was measured at native coronary segments: pre-stent, post-stent, distal segments and at coronary plaques. Lumen attenuation increase (LAI) ratio was calculated for all stents. Heart rate (HR) variation, premature heart beats (PHB), heat sensation (HS), blooming and beam hardening were also assessed. Results: Image quality was similar between groups, with no significant difference (Likert score 4.48 ± 0.75 vs 4.54 ± 0.65, p = 0.5). There were similarities in LAI ratio between I-370 and I-320 (0.39 ± 0.42 vs 0.48 ± 0.44 HU, p = 0.08). Regarding lumen mean attenuation at native coronary segments, a significant difference was observed, with I-320 presenting lower values, including contrast mean attenuation in distal segments. After statistical multivariate analysis, three variables correlated with stent image quality: 1) stent diameter, 2) HR variation and 3) stent lumen LAI ratio. Conclusions: There was no significant difference between Iopamidol-370 mgI ml−1 and Ioversol-320 mgI ml−1 contrasts regarding overall stent lumen image quality, which was mainly influenced by stent diameter, HR and LAI ratio. Advances in knowledge: Coronary CTA allows adequate stents' visualization and image quality is influenced by stent diameter, HR variation and LAI ratio. Stents' image quality showed no difference between different concentration contrasts (I-370 vs. I-320); however, higher concentration contrasts may provide an improved overall visualization, especially regarding coronary distal segments.

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Comparison of image quality and radiation dose using different pre-ASiR-V and post-ASiR-V levels in coronary computed tomography angiography

Journal of X-Ray Science and Technology ◽

10.3233/xst-200754 ◽

2020 ◽

pp. 1-10

Author(s):

Yongxia Zhao ◽

Dongxue Li ◽

Zhichao Liu ◽

Xue Geng ◽

Tianle Zhang ◽

...

Keyword(s):

Computed Tomography ◽

Image Quality ◽

Radiation Dose ◽

Computed Tomography Angiography ◽

Coronary Computed Tomography Angiography ◽

Effective Radiation Dose ◽

Dose Length Product ◽

Coronary Computed Tomography ◽

Significant Difference ◽

Noise Ratio

OBJECTIVE: To determine the optimal pre-adaptive and post-adaptive level statistical iterative reconstruction V (ASiR-V) for improving image quality and reducing radiation dose in coronary computed tomography angiography (CCTA). METHODS: The study was divided into two parts. In part I, 150 patients for CCTA were prospectively enrolled and randomly divided into 5 groups (A, B, C, D, and E) with progressive scanning from 40% to 80% pre-ASiR-V with 10% intervals and reconstructing with 70% post-ASiR-V. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was assessed using a 5-point scale. The CT dose index volume (CTDIvol) and dose-length product (DLP) of each patient were recorded and the effective radiation dose (ED) was calculated after statistical analysis by optimizing for the best pre-ASiR-V value with the lowest radiation dose while maintaining overall image quality. In part II, the images were reconstructed with the recommended optimal pre-ASiR-V values in part I (D group) and 40%–90% of post-ASiR-V. The reconstruction group (D group) was divided into 6 subgroups (interval 10%, D0:40% post-ASiR-V, D1:50% post - ASiR-V, D2:60% post-ASiR-V, D3:70% post-ASiR-V, D4:80% post-ASiR-V, and D5:90% post-ASiR-V).The SNR and CNR of D0-D5 subgroups were calculated and analyzed using one-way analysis of variance, and the consistency of the subjective scores used the k test. RESULTS: There was no significant difference in the SNRs, CNRs, and image quality scores among A, B, C, and D groups (P > 0.05). The SNR, CNR, and image quality scores of the E group were lower than those of the A, B, C, and D groups (P < 0.05). The mean EDs in the B, C, and D groups were reduced by 7.01%, 13.37%, and 18.87%, respectively, when compared with that of the A group. The SNR and CNR of the D4–D5 subgroups were higher than the D0-D3 subgroups, and the image quality scores of the D4 subgroups were higher than the other subgroups (P < 0.05). CONCLUSION: The wide-detector combined with 70% pre-ASiR-V and 80% post-ASiR-V significantly reduces the radiation dose of CCTA while maintaining overall image quality as compared with the manufacture’s recommendation of 40% pre-ASiR-V.

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Increased Circulating Malondialdehyde-Modified Low-Density Lipoprotein Level Is Associated with High-Risk Plaque in Coronary Computed Tomography Angiography in Patients Receiving Statin Therapy

Journal of Clinical Medicine ◽

10.3390/jcm10071480 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1480

Author(s):

Keishi Ichikawa ◽

Toru Miyoshi ◽

Kazuhiro Osawa ◽

Takashi Miki ◽

Hiroshi Ito

Keyword(s):

Computed Tomography ◽

High Risk ◽

Statin Therapy ◽

Computed Tomography Angiography ◽

Coronary Computed Tomography Angiography ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Coronary Cta ◽

Coronary Computed Tomography

Objective: To evaluate the association of serum malondialdehyde low-density lipoprotein (MDA-LDL), an oxidatively modified LDL, with the prevalence of high-risk plaques (HRP) determined with coronary computed tomography angiography (CTA) in statin-treated patients. Methods: This study was a single-center retrospective cohort comprising 268 patients (mean age 67 years, 58% men) with statin therapy and who underwent coronary CTA for suspected stable coronary artery disease. Patients were classified into two groups according to median MDA-LDL level or median LDL-C level. Coronary CTA-verified HRP was defined when two or more characteristics, including positive remodeling, low-density plaques, and spotty calcification, were present. Results: Patients with HRP had higher MDA-LDL (p = 0.011), but not LDL-C (p = 0.867) than those without HRP. High MDA-LDL was independently associated with HRP (odds ratio 1.883, 95% confidential interval 1.082–3.279) after adjustment for traditional risk factors. Regarding incremental value of MDA-LDL for predicting CTA-verified HRP, addition of serum MDA-LDL levels to the baseline model significantly increased global chi-square score from 26.1 to 32.8 (p = 0.010). Conclusions: A high serum MDA-LDL level is an independent predictor of CTA-verified HRP, which can lead to cardiovascular events in statin-treated patients.

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