HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Quicktime movie All Versions of this Article: 2292021114v1 229/2/483    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boehm, T. Articles by Wildermuth, S. Search for Related Content PubMed PubMed Citation Articles by Boehm, T. Articles by Wildermuth, S.

Thin-Section CT of the Lung: Does Electrocardiographic Triggering Influence Diagnosis?¹

¹ From the Department of Medical Radiology, Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland (T.B., J.K.W., P.R.H., D.W., D.W.C., B.M., S.W.); and Department of Biostatistics, ISPM, University of Zürich, Switzerland (B.S.). Received September 4, 2002; revision requested November 7; final revision received February 26, 2003; accepted April 16. Supported by the NCCR CO-ME of the Swiss National Science Foundation. Address correspondence to T.B. (e-mail: thomas_boehm@gmx.net).

PURPOSE: To determine the impact of prospective electrocardiographic (ECG) triggering on image quality and diagnostic outcome of thin-section computed tomography (CT) of the lung.

MATERIALS AND METHODS: Forty-five consecutive patients referred for thin-section CT of the lung were examined with prospectively ECG-triggered and nontriggered thin-section CT of the lung with a multi–detector row helical CT scanner. Subjective image quality criteria (image noise, motion artifacts, and diagnostic accessibility) were rated by three radiologists in consensus for the upper lobe, middle lobe and/or lingula, and lower lobe. Pathologic changes were assessed for the various lobes, and a diagnosis was assigned. The diagnoses were compared by two radiologists in consensus to determine the effects of CT technique on diagnostic outcome. Quantitative measurements were performed, including determination of image noise and signal-to-noise ratios in different anatomic regions. The Wilcoxon signed rank test and paired sign test (both with Bonferroni correction) were used for statistical analysis.

RESULTS: Subjective assessment showed significant differences in motion artifact reduction in the middle lobe, lingula, and left lower lobe. The diagnostic assessibility of triggered CT was rated significantly higher only for the left lower lobe compared with nontriggered data acquisition. No differences in diagnostic outcome were determined between triggered and nontriggered techniques. Mean image noise in tracheal air was 68.2 ± 17 (SD) for triggered CT versus 37.4 ± 9 for nontriggered CT (P < .05). Mean signal-to-noise ratio in the upper versus lower lobes was 22.5 ± 8 versus 25.4 ± 10 for triggered and 35.6 ± 9 versus 39.2 ± 10 for nontriggered techniques (P < .05).

CONCLUSION: Given the lack of improvement in diagnostic accuracy and the need for additional resources, ECG-triggered thin-section CT of the lung is not recommended for routine clinical practice.

Supplemental material: radiology.rsnajnls.org/cgi/content/full/2292021114/DC1

© RSNA, 2003

Index terms: Computed tomography (CT), technology, 60.12111 • Computed tomography (CT), thin-section, 60.12118 • Electrocardiography (ECG) • Lung, CT, 60.12111, 60.12118

This article has been cited by other articles:

				H. I. Ha, H. W. Goo, J. B. Seo, J.-W. Song, and J. S. Lee Effects of high-resolution CT of the lung using partial versus full reconstruction on motion artifacts and image noise. Am. J. Roentgenol., September 1, 2006; 187(3): 618 - 622. [Abstract] [Full Text] [PDF]

				V. D. Raptopoulos, P. B. Boiselle, N. Michailidis, J. Handwerker, A. Sabir, J. A. Edlow, I. Pedrosa, and J. B. Kruskal MDCT Angiography of Acute Chest Pain: Evaluation of ECG-Gated and Nongated Techniques Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S346 - S356. [Abstract] [Full Text] [PDF]

				S. M Kymes, K. Lee, J. W Fletcher, and SNAP (CSP 027) Study Group Assessing diagnostic accuracy and the clinical value of positron emission tomography imaging in patients with solitary pulmonary nodules (SNAP) Clinical Trials, February 1, 2006; 3(1): 31 - 42. [Abstract] [PDF]

				U. Studler, T. Gluecker, G. Bongartz, J. Roth, and W. Steinbrich Image Quality from High-Resolution CT of the Lung: Comparison of Axial Scans and of Sections Reconstructed from Volumetric Data Acquired Using MDCT Am. J. Roentgenol., September 1, 2005; 185(3): 602 - 607. [Abstract] [Full Text] [PDF]

				T. Schertler, S. Wildermuth, J. K. Willmann, H. Alkadhi, B. Marincek, and T. Boehm Effects of ECG Gating and Postprocessing Techniques on 3D MDCT of the Bronchial Tree Am. J. Roentgenol., July 1, 2004; 183(1): 83 - 89. [Abstract] [Full Text] [PDF]