Abstract
We evaluated the feasibility and image quality of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA) using a body surface area (BSA) protocol for contrast-medium (CM) administration on both second- and third-generation scanners (Flash and Force CT), without using heart rate control. One-hundred-and-eighty patients with suspected coronary heart disease undergoing CCTA were divided into groups A (BSA protocol for CM on Flash CT), B (body mass index (BMI)-matched patients; BMI protocol for CM on Flash CT), and C (BMI-matched patients; BSA protocol for CM on Force CT). Patient characteristics, quantitative and qualitative measures, and radiation dose were compared between groups A and B, and A and C. Of the 180 patients, 99 were male (median age, 62 years). Average BSA in groups A, B, and C was 1.80 ± 0.17 m2, 1.74 ± 0.16 m2, and 1.64 ± 0.17 m2, respectively, with groups A and C differing significantly (P < 0.001). Contrast volume (50.50 ± 8.57 mL vs. 45.00 ± 6.18 mL) and injection rate (3.90 ± 0.44 mL/s vs. 3.63 ± 0.22 mL/s) differed significantly between groups A and C (P < 0.001). Groups A and C (both: all CT values > 250 HU, average scores > 4) achieved slightly lower diagnostic image quality than group B. The BSA protocol for CM administration was feasible in both Flash and Force CT, and therefore may be valuable in clinical practice.
Highlights
We evaluated the feasibility and image quality of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA) using a body surface area (BSA) protocol for contrast-medium (CM) administration on both second- and third-generation scanners (Flash and Force CT), without using heart rate control
With the increase in the number of examinations, the use of iodinated CM for CCTA has become a concern, as it may lead to contrast-induced nephropathy (CIN)[8,9,10,11], and CM remaining in the right cardiac cavity after the scan is not useful
We first compared the image quality of the three main coronary arteries visualized with a second-generation dual-source CT (DSCT) scanner, using a BSA protocol for CM administration in step-and-shoot CCTA, without heart rate control, with that of a body mass index (BMI) protocol
Summary
We evaluated the feasibility and image quality of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA) using a body surface area (BSA) protocol for contrast-medium (CM) administration on both second- and third-generation scanners (Flash and Force CT), without using heart rate control. In this study, we aimed to establish whether using a BSA protocol for CM administration, which involved using less CM, and adjusting the injection rate, was feasible in step-and-shoot CCTA To this end, we first compared the image quality of the three main coronary arteries visualized with a second-generation DSCT scanner, using a BSA protocol for CM administration in step-and-shoot CCTA, without heart rate control, with that of a BMI protocol. We compared the image quality obtained with this BSA protocol between secondgeneration and third-generation DSCT scanners
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