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Dual-source CT coronary angiography: prospective versus retrospective acquisition technique

Angiografia coronarica mediante TC dual source: tecnica di acquisizione prospettica versus retrospettiva

  • Cardiac Radiology / Cardioradiologia
  • Published:
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Abstract

Purpose

The aim of our work was to compare image quality and radiation dose in a group of patients who underwent cardiac dual-source computed tomography (DSCT) with prospective electrocardiographic (ECG) gating with those of a control group studied with retrospective gating.

Materials and methods

Sixty patients were randomly assigned to two groups of 30 individuals each. Patients with heart rates >70 bpm and body mass index (BMI) >30 kg/m2 were excluded. Group A was examined with prospective ECG gating and group B with retrospective gating. The dose-length product (DLP) was recorded to calculate the radiation dose, whereas the effective dose was normalised to a standard 12-cm scan of the heart.

Results

Applying the best reconstruction interval, 98.6% of segments in the prospective group and 99.3% in the retrospective group were diagnostic. No significant difference (p>0.05) in image quality was observed between groups. Mean normalised radiation dose was 4.91±0.4 mSv in the prospective-gating group and 14.62 mSv±4.36 in the retrospective-gating group (p<0.01).

Conclusions

Coronary CT with prospective ECG gating, a standard feature on new scanners, allows for a significant reduction in radiation dose without causing any significant decrease in image quality or in the number of segments assessed. The prospective technique is thus recommended for patients with heart rates £70 bpm and BMI £30 kg/m2.

Riassunto

Obiettivo

Lo scopo del nostro lavoro è di comparare la qualità d’immagine e la dose di radiazioni degli esami di un gruppo di pazienti sottoposto ad angiografia coronarica con tomografia computerizzata (TC) dual source (TCDS) con tecnica di sincronizzazione prospettica dell’elettrocardiogramma rispetto ad un gruppo di controllo studiato con tecnica di sincronizzazione retrospettiva.

Materiali e metodi

Sono stati studiati 60 pazienti randomizzati in due gruppi di 30 pazienti ciascuno. Sono stati esclusi dallo studio pazienti con frequenza cardiaca >70 battiti per minuto (bpm) e body mass index (BMI)>30 kg/m2. Il gruppo A è stato studiato con una tecnica di sincronizzazione prospettica, mentre nel gruppo B è stata applicata una tecnica retrospettiva. Per il calcolo della dose di radiazioni è stato registrato il dose lenght product (DLP) e la dose effettiva è stata normalizzata per la lunghezza di una scansione standard del cuore di 12 cm.

Risultati

Applicando il miglior intervallo di ricostruzione sono risultati diagnostici il 98,6% dei segmenti nel gruppo prospettico ed il 99,3% in quello retrospettivo. Non è stata osservata nessuna differenza significativa nella qualità delle immagini dei due gruppi (p>0,05). La dose normalizzata di radiazioni è stata di 4,91±0,4 mSv per il gruppo prospettico, e di 14,62 mSv±4,36 per il gruppo retrospettivo (p<0,01).

Conclusioni

La TC coronarica con tecnica di sincronizzazione prospettica, utilizzabile negli scanners di ultima generazione, permette una significativa riduzione della dose di radiazioni somministrata al paziente senza determinare alcuna riduzione rilevante nella qualità delle immagini e nel numero di segmenti valutabili. Per tale ragione, è attualmente consigliabile l’ utilizzo di tale tecnica nei soggetti che presentano una frequenza cardiaca inferiore ai 70 bpm ed un BMI inferiore ai 30 kg/m2.

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Authors and Affiliations

  1. Dipartimento di Radiologia Cardiovascolare, Ospedale San Camillo-Forlanini, Circonvallazione Gianicolense 87, 00152, Rome, Italy

    C.N. De Cecco, V. Buffa, S. Fedeli, A. Vallone, R. Ruopoli & M. Luzietti

  2. Dipartimento di Cardiochirurgia, Ospedale San Camillo-Forlanini, Circonvallazione Gianicolense 87, 00152, Rome, Italy

    F. Musumeci

  3. Dipartimento di Radiologia d’Emergenza, Ospedale San Camillo-Forlanini, Circonvallazione Gianicolense 87, 00152, Rome, Italy

    V. Miele, M. Maurizi Enrici & V. David

  4. Dipartimento di Scienze Radiologiche, Università di Roma “Sapienza” — Ospedale Sant’Andrea, Via di Grottarossa 1035, 00189, Rome, Italy

    C.N. De Cecco

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  1. C.N. De Cecco
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  2. V. Buffa
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Correspondence to C.N. De Cecco.

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De Cecco, C., Buffa, V., Fedeli, S. et al. Dual-source CT coronary angiography: prospective versus retrospective acquisition technique. Radiol med 116, 178–188 (2011). https://doi.org/10.1007/s11547-010-0584-2

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