Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Published online before print June 23, 2008, 10.1148/radiol.2482071804
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
2482071804v1
248/2/424    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hirai, N.
Right arrow Articles by Ito, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hirai, N.
Right arrow Articles by Ito, K.
Related Collections
Right arrowRelated Article
(Radiology 2008;248:424-430.)
© RSNA, 2008

Cardiac Imaging

Prospective versus Retrospective ECG-gated 64-Detector Coronary CT Angiography: Assessment of Image Quality, Stenosis, and Radiation Dose1

Nobuhiko Hirai, MD, Jun Horiguchi, MD, Chikako Fujioka, RT, Masao Kiguchi, RT, Hideya Yamamoto, MD, Noriaki Matsuura, MD, Toshiro Kitagawa, MD, Hiroki Teragawa, MD, Nobuoki Kohno, MD, and Katsuhide Ito, MD

1 From the Department of Clinical Radiology, Hiroshima University Hospital, 1-2-3 Kasumi-cho, Minami-ku, Hiroshima 734-8551, Japan (N.H., J.H., C.F., M.K.), and Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Programs for Applied Biomedicine (H.Y., T.K., N.K.); Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine (N.M., K.I.); and Department of Medicine and Molecular Science (H.T.), Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. Received October 15, 2007; revision requested December 13; revision received January 14, 2008; accepted February 28; final version accepted March 5. Address correspondence to J.H. (e-mail: horiguch{at}hiroshima-u.ac.jp).

Purpose: To show that prospective electrocardiographically (ECG)-triggered coronary computed tomographic (CT) angiography (hereafter, prospective CT angiography) is at least as effective as retrospective ECG-gated coronary CT angiography (hereafter, retrospective CT angiography).

Materials and Methods: Institutional review committee approval and informed consent were obtained. Sixty patients with heart rates of less than 75 beats per minute who were referred for coronary CT angiography were enrolled. Both prospective and retrospective CT angiography were performed with a 64-detector scanner. Data acquisition times were recorded. Two independent cardiac radiologists evaluated subjective image quality (1, excellent; 4, poor) and severity of stenosis (0% occlusion, 1%–49% occlusion, 50%–75% occlusion, and >75% occlusion) with the 17-segment American Heart Association classification model. Discrepancies were settled by consensus. Effective radiation doses of prospective and retrospective CT angiography were calculated with volume CT dose index. Data regarding acquisition time and radiation exposure for prospective and retrospective CT angiography were compared. The Student t test was performed, and {kappa} statistics were calculated.

Results: Mean data acquisition time of prospective CT angiography was shorter than that of retrospective CT angiography (5.6 seconds ± 1.1 [standard deviation] vs 6.7 seconds ± 1.1, respectively; P < .01). Consensus-determined image quality in coronary artery branches was similar between prospective CT angiography and retrospective CT angiography (1.15 vs 1.13, respectively; P = .992). Excellent agreement between prospective CT angiography and retrospective CT angiography was observed in the detection of significant (≥50% occlusion) coronary artery stenoses per segment ({kappa} = 0.882) and in the grading of stenoses per patient ({kappa} = 0.829). Calculated effective dose with prospective CT angiography was 79% lower than that with retrospective CT angiography (4.1 mSv ± 1.8 vs 20.0 mSv ± 3.5, respectively; P < .001).

Conclusion: Prospective CT angiography can reduce radiation dose below that of retrospective CT angiography with dose modulation, while maintaining image quality and the ability to assess luminal obstructions in patients with heart rates of less than 75 beats per minute.

© RSNA, 2008


Related Article

Prospective versus Retrospective ECG Gating for 64-Detector CT of the Coronary Arteries: Comparison of Image Quality and Patient Radiation Dose
William P. Shuman, Kelley R. Branch, Janet M. May, Lee M. Mitsumori, David W. Lockhart, Theodore J. Dubinsky, Bill H. Warren, and James H. Caldwell
Radiology 2008 248: 431-437. [Abstract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Am. J. Roentgenol.Home page
C. Fujioka, J. Horiguchi, M. Kiguchi, H. Yamamoto, T. Kitagawa, and K. Ito
Survey of Aorta and Coronary Arteries With Prospective ECG-Triggered 100-kV 64-MDCT Angiography
Am. J. Roentgenol., July 1, 2009; 193(1): 227 - 233.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
A. C. Weustink, N. R. Mollet, L. A. Neefjes, M. van Straten, E. Neoh, S. Kyrzopoulos, B. W. Meijboom, C. van Mieghem, F. Cademartiri, P. J. de Feyter, et al.
Preserved Diagnostic Performance of Dual-Source CT Coronary Angiography with Reduced Radiation Exposure and Cancer Risk
Radiology, July 1, 2009; 252(1): 53 - 60.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
G. L. Raff, K. M. Chinnaiyan, D. A. Share, T. Y. Goraya, E. A. Kazerooni, M. Moscucci, R. E. Gentry, A. Abidov, and for the Advanced Cardiovascular Imaging Consortium
Radiation Dose From Cardiac Computed Tomography Before and After Implementation of Radiation Dose-Reduction Techniques
JAMA, June 10, 2009; 301(22): 2340 - 2348.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol ImgHome page
S. Achenbach, V. Dilsizian, C. M. Kramer, and W. A. Zoghbi
The Year in Coronary Artery Disease
J. Am. Coll. Cardiol. Img., June 1, 2009; 2(6): 774 - 786.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
W. P. Shuman, K. R. Branch, J. M. May, L. M. Mitsumori, J. N. Strote, B. H. Warren, T. J. Dubinsky, D. W. Lockhart, and J. H. Caldwell
Whole-Chest 64-MDCT of Emergency Department Patients with Nonspecific Chest Pain: Radiation Dose and Coronary Artery Image Quality with Prospective ECG Triggering Versus Retrospective ECG Gating
Am. J. Roentgenol., June 1, 2009; 192(6): 1662 - 1667.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
K. M. Takakuwa, E. J. Halpern, E. L. Gingold, D. C. Levin, and F. S. Shofer
Radiation Dose in a "Triple Rule-Out" Coronary CT Angiography Protocol of Emergency Department Patients Using 64-MDCT: The Impact of ECG-Based Tube Current Modulation on Age, Sex, and Body Mass Index
Am. J. Roentgenol., April 1, 2009; 192(4): 866 - 872.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
T. Pflederer, L. Rudofsky, D. Ropers, S. Bachmann, M. Marwan, W. G. Daniel, and S. Achenbach
Image Quality in a Low Radiation Exposure Protocol for Retrospectively ECG-Gated Coronary CT Angiography
Am. J. Roentgenol., April 1, 2009; 192(4): 1045 - 1050.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
L. Husmann, B. A. Herzog, O. Gaemperli, F. Tatsugami, N. Burkhard, I. Valenta, P. Veit-Haibach, C. A. Wyss, U. Landmesser, and P. A. Kaufmann
Diagnostic accuracy of computed tomography coronary angiography and evaluation of stress-only single-photon emission computed tomography/computed tomography hybrid imaging: comparison of prospective electrocardiogram-triggering vs. retrospective gating
Eur. Heart J., March 1, 2009; 30(5): 600 - 607.
[Abstract] [Full Text] [PDF]