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Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

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Abstract

The purpose of this study was to compare coronary 64-slice CT angiography (CTA) protocols, specifically prospective electrocardiograph (ECG)-triggered and retrospective ECG-gated CT acquisition performed using a tube voltage of 140 kV and 120 kV, regarding intracoronary stent imaging. Coronary artery stents (n = 12) with artificial in-stent restenosis (50% luminal reduction, 40 HU) on a cardiac phantom were examined by CT at heart rates of 50–75 beats per minute (bpm). The subjective visibility of in-stent restenosis was evaluated with a three-point scale (1 clearly visible, 2 visible, and 3 not visible), and artificial lumen narrowing [(inner stent diameter − measured lumen diameter)/inner stent diameter], lumen attenuation increase ratio [(in-stent attenuation − coronary lumen attenuation)/coronary lumen attenuation], and signal-to-noise ratio of in-stent lumen were determined. The effective dose was estimated. The artificial lumen narrowing (mean 43%), the increase of lumen attenuation (mean 46%), and signal-to-noise ratio (mean 7.8) were not different between CT acquisitions (p = 0.12–0.91). However, the visibility scores of in-stent restenosis were different (p < 0.05) between ECG-gated CTA techniques: (a) 140-kV prospective (effective dose 4.6 mSv), 1.6; (b) 120-kV prospective (3.3 mSv), 1.8; (c) 140-kV retrospective (16.4–18.8 mSv), 1.9; and (d) 120-kV retrospective (11.0–13.4 mSv), 1.9. Thus, 140-kV prospective ECG-triggered CTA improves coronary in-stent restenosis visibility at a lower radiation dose compared with retrospective ECG-gated CTA.

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Acknowledgements

This study was financially supported by the Tsuchiya Foundation (http://www.tsuchiya-foundation.or.jp), Hiroshima, Japan.

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Authors and Affiliations

  1. Department of Clinical Radiology, Hiroshima University Hospital, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan

    Jun Horiguchi, Chikako Fujioka, Masao Kiguchi & Shingo Kohno

  2. Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan

    Hideya Yamamoto & Toshiro Kitagawa

  3. Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan

    Katsuhide Ito

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  1. Jun Horiguchi
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  2. Chikako Fujioka
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  3. Masao Kiguchi
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  4. Hideya Yamamoto
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  5. Toshiro Kitagawa
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  7. Katsuhide Ito
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Correspondence to Jun Horiguchi.

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Horiguchi, J., Fujioka, C., Kiguchi, M. et al. Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT. Eur Radiol 19, 2363–2372 (2009). https://doi.org/10.1007/s00330-009-1419-1

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  • DOI: https://doi.org/10.1007/s00330-009-1419-1

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