American Journal of Cardiology
Volume 104, Issue 10 , Pages 1343-1350 , 15 November 2009

Comparison of Image Quality and Radiation Dose of Coronary Computed Tomographic Angiography Between Conventional Helical Scanning and a Strategy Incorporating Sequential Scanning

  • Andrew J. Einstein, MD, PhD

      Affiliations

    • Department of Medicine, Cardiology Division, Columbia University Medical Center, New York, New York
    • Department of Radiology, Columbia University Medical Center, New York, New York
    • Corresponding Author InformationCorresponding author: Tel: 212-305-4275; fax: 212-305-4648
  • ,
  • Steven D. Wolff, MD, PhD

      Affiliations

    • Department of Medicine, Cardiology Division, Columbia University Medical Center, New York, New York
    • Department of Radiology, Columbia University Medical Center, New York, New York
    • Advanced Cardiovascular Imaging, New York, New York
  • ,
  • Eric D. Manheimer, MD

      Affiliations

    • Department of Medicine, Cardiology Division, Columbia University Medical Center, New York, New York
  • ,
  • James Thompson, DO

      Affiliations

    • Advanced Cardiovascular Imaging, New York, New York
  • ,
  • Sylvia Terry, RT(CT)

      Affiliations

    • Advanced Cardiovascular Imaging, New York, New York
  • ,
  • Seth Uretsky, MD

      Affiliations

    • Advanced Cardiovascular Imaging, New York, New York
    • St. Luke's–Roosevelt Hospital, New York, New York
  • ,
  • Adalbert Pilip, MD

      Affiliations

    • Advanced Cardiovascular Imaging, New York, New York
  • ,
  • M. Robert Peters, MD

      Affiliations

    • Department of Radiology, Columbia University Medical Center, New York, New York
    • Advanced Cardiovascular Imaging, New York, New York

Received 22 March 2009 ,Revised 2 July 2009 ,Accepted 2 July 2009.

References 

  1. Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, et al. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation. 2006;114:1761–1791
  2. Nieman K, Cademartiri F, Lemos P, Raaijmakers R, Pattynama PMT, de Feyter PJ. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation. 2002;106:2051–2054
  3. Meijboom WB, van Mieghem CAG, Mollet NR, Pugliese F, Weustink AC, van Pelt N, et al. 64-Slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery stenosis. J Am Coll Cardiol. 2007;50:1469–1475
  4. Meijboom WB, Meijs MFL, Schuijf JD, Cramer MJ, Mollet NR, van Mieghem CAG, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography. J Am Coll Cardiol. 2008;52:2135–2144
  5. Einstein AJ, Moser KW, Thompson RC, Cerqueira MD, Henzlova MD. Radiation dose to patients from cardiac diagnostic imaging. Circulation. 2007;116:1290–1305
  6. Coles DR, Smail MA, Negus IS, Wilde P, Oberhoff M, Karsch KR, et al. Comparison of radiation doses from multislice computed tomography coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol. 2006;47:1840–1845
  7. Leung KC, Martic CJ. Effective doses for coronary angiography. Br J Radiol. 1996;69:426–431
  8. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–323
  9. Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, et al. Estimated radiation dose associated with cardiac CT angiography. JAMA. 2009;301:500–507
  10. Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, et al. Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol. 2002;12:1081–1086
  11. Abada HT, Larchez C, Daoud B, Sigal-Cinqualbre A, Paul JF. MDCT of the coronary arteries: feasibility of low-dose CT with ECG-pulsed tube current modulation to reduce radiation dose. Am J Roentgenol. 2006;186(suppl):S387–S390
  12. Hsieh J, Londt J, Vass M, Li J, Tang X, Okerlund D. Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. Med Phys. 2006;33:4236–4248
  13. European guidelines on quality criteria for computed tomography. http://www.drs.dk/guidelines/ct/quality/index.htmAccessed August 5, 2009
  14. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  15. Gutstein A, Wolak A, Lee C, Dey D, Ohba M, Suzuki Y, et al. Predicting success of prospective and retrospective gating with dual-source coronary computed tomography angiography: development of selection criteria and initial experience. J Cardiovasc Comput Tomogr. 2008;2:81–90
  16. Hirai N, Horiguchi J, Fukioka C, Kiguchi M, Yamamoto H, Matsuura N, et al. Prospective versus retrospective ECG-gated 64-detector coronary CT angiography: assessment of image quality, stenosis, and radiation dose. Radiology. 2008;248:424–430
  17. Shuman WP, Branch KR, May JM, Mitsumori LM, Lockhart DW, Dubinsky TJ, et al. Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology. 2008;248:431–437
  18. Earls JP, Berman EL, Urban BA, Curry CA, Lane JL, Jennings RS, et al. Prospectively gated transverse coronary CT angiography versus retrospectively gated helical technique: improved image quality and reduced radiation dose. Radiology. 2008;246:742–753
  19. Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation. 2006;113:1305–1310
  20. Alkadhi H, Stolzmann P, Scheffel H, Desbiolles L, Baumuller S, Plass A, et al. Radiation dose of cardiac dual-source CT: the effect of tailoring the protocol to patient-specific parameters. Eur J Radiol. 2008;68:385–391
  21. Scheffel H, Alkadhi H, Leschka S, Plass A, Desbiolles L, Guber I, et al. Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart. 2008;94:1132–1137
  22. Husmann L, Valenta I, Gaemperli O, Adda O, Treyer V, Wyss CA, et al. Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J. 2008;29:191–197
  23. Horiguchi J, Kiguchi M, Fujioka C, Shen Y, Arie R, Sunasaka K, et al. Radiation dose, image quality, stenosis measurement, and CT densitometry using ECG-triggered coronary 64-MDCT angiography: a phantom study. Am J Roentgenol. 2008;190:315–320
  24. Earls JP, Schrack EC. Prospectively gated low-dose CCTA: 24 months experience in more than 2,000 clinical cases. Int J Cardiovasc Imaging. 2009;25:177–187
  25. Gutstein A, Dey D, Cheng V, Wolak A, Gransar H, Suzuki Y, et al. Algorithm for radiation dose reduction with helical dual source coronary computed tomography angiography in clinical practice. J Cardiovasc Comput Tomogr. 2008;2:311–322
  26. Meyer T, Hein F, Martinoff S, Schoemig A, Hausleiter J. Radiation exposure and dose reduction measures in cardiac CT. Curr Cardiovasc Imaging Rep. 2008;1:133–140
  27. Primak AN, McCollough CH, Bruesewitz MR, Zhang J, Fletcher JG. Relationship between noise, dose, and pitch in cardiac multi-detector row CT. Radiographics. 2006;26:1785–1794
  28. Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Med Decis Making. 1991;11:88–94

 Dr. Einstein is supported in part by K12 Institutional Career Development Award 5 KL2 RR024157-03 from the National Institutes of Health, Bethesda, Maryland.

PII: S0002-9149(09)01325-3

doi: 10.1016/j.amjcard.2009.07.003

American Journal of Cardiology
Volume 104, Issue 10 , Pages 1343-1350 , 15 November 2009