Assessment of image quality and radiation dose of prospectively ECG-triggered adaptive dual-source coronary computed tomography angiography (cCTA) with arrhythmia rejection algorithm in systole versus diastole: A retrospective cohort study

Ashley M. Lee, Jonathan Beaudoin, Leif Christopher Engel, Manavjot S. Sidhu, Suhny Abbara, Thomas J. Brady, Udo Hoffmann, Brian B. Ghoshhajra

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

In this study, we sought to evaluate the image quality and effective radiation dose of prospectively ECGtriggered adaptive systolic (PTA-systolic) dual-source CTA versus prospectively triggered adaptive diastolic (PTA-diastolic) dual-source CTA in patients of unselected heart rate and rhythm. This retrospective cohort study consisted of 41 PTA-systolic and 41 matched PTA-diastolic CTA patients whom underwent clinically indicated 128-slice dual source CTA between December 2010 to June 2012. Image quality and motion artifact score (both on a Likert scale 1-4 with 4 being the best), effective dose, and CTDIvol were compared. The effect of heart rate (HR) and heart rate variability [HRV] on imagemotion artifact score and CTDIvol was analyzedwith Pearson's correlation coefficient. All 82 exams were considered diagnostic with 0 non-diagnostic segments. PTA-systolic CTA patients had a higher maximum HR, wider HRV, were less likely to be in sinus rhythm, and received less beta-blocker vs. PTA-diastolic CTA patients. No difference in effective dose was observed (PTA-systolic vs. PTA-diastolic CTA: 2.9 vs. 2.2 mSv, p = 0.26). Image quality score (3.3 vs. 3.5, p<0.05) and motion artifact score (3.5 vs. 3.8, p<0.05) were lower in PTA-systolic CTAs than in PTA-diastolic CTAs. For PTA-systolic CTAs, an increase in HR was not associated with a negative impact onmotion artifact score nor CTDI vol. For PTA-diastolic CTA, an increase in HR was associated with increased motion artifacts and CTDI vol. HRV demonstrated no correlation with motion artifact and CTDI vol for both PTA-systolic and PTA-diastolic CTAs. In conclusion, both PTA-diastolic CTA and PTA-systolic CTA yielded diagnostic examinations at unselected heart rates and rhythms with similar effective radiation, but PTA-systolic CTA resulted in more consistent radiation exposure and image quality across a wide range of rates and rhythms.

Original languageEnglish (US)
Pages (from-to)1361-1370
Number of pages10
JournalInternational Journal of Cardiovascular Imaging
Volume29
Issue number6
DOIs
StatePublished - Aug 1 2013

Keywords

  • Coronary computed tomography angiography
  • Radiation dosage
  • Systole

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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