Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate

Patricia Carrascosa, Carlos Capuñay, Alejandro Deviggiano, Alejandro Goldsmit, Carlos Tajer, Marcelo Bettinotti, Jorge Carrascosa, Thomas B. Ivanc, Arzhang Fallahi, Mario J. Garcia

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Desirable methods for cardiac CT angiography would both reduce radiation exposure from cardiac CT angiography and preserve accuracy. Objectives: We assessed image quality, radiation dose, and diagnostic accuracy of a low-dose, prospectively gated axial cardiac CT angiography protocol for the evaluation of patients with suspected coronary artery disease (CAD). Methods: Fifty consecutive patients referred for diagnostic invasive coronary angiography (ICA) and with a stable heart rate < 60 beats/min after β-blocker administration were prospectively enrolled in a single center study. Subjects underwent CT angiography with a 64-row multidetector CT scanner with a prospectively gated axial imaging protocol. If the examination was determined to be nondiagnostic, then a retrospectively gated helical scan was performed. Two reviewers independently assessed image quality and the presence of significant coronary artery stenosis (>50%). Results: Prospectively gated CT angiography was successfully performed in 46 of 50 patients. Of 794 coronary segments, 777 were determined to be of diagnostic image quality. The overall patient-based sensitivity (95% CI), specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of significant coronary stenosis were 100% (87%-100%), 75% (53%-90%), 81% (64%-93%), 100% (81%-100%), and 88% (81%-95%), respectively. The mean effective radiation dose for CT angiography and ICA were 3.4 ± 0.4 mSv and 6.9 ± 0.8 mSv, respectively. Conclusions: Cardiac CT angiography performed in a prospectively gated axial mode with 64-row multidetector CT provides an accurate, low-dose alternative for the detection of CAD.

Original languageEnglish (US)
Pages (from-to)197-205
Number of pages9
JournalJournal of Cardiovascular Computed Tomography
Volume4
Issue number3
DOIs
StatePublished - May 2010
Externally publishedYes

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Coronary Stenosis
Coronary Angiography
Heart Rate
Coronary Artery Disease
Radiation
Computed Tomography Angiography

Keywords

  • Computed tomography
  • Coronary angiography
  • Coronary artery disease
  • Prospective ECG triggering
  • Radiation exposure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate. / Carrascosa, Patricia; Capuñay, Carlos; Deviggiano, Alejandro; Goldsmit, Alejandro; Tajer, Carlos; Bettinotti, Marcelo; Carrascosa, Jorge; Ivanc, Thomas B.; Fallahi, Arzhang; Garcia, Mario J.

In: Journal of Cardiovascular Computed Tomography, Vol. 4, No. 3, 05.2010, p. 197-205.

Research output: Contribution to journalArticle

Carrascosa, Patricia ; Capuñay, Carlos ; Deviggiano, Alejandro ; Goldsmit, Alejandro ; Tajer, Carlos ; Bettinotti, Marcelo ; Carrascosa, Jorge ; Ivanc, Thomas B. ; Fallahi, Arzhang ; Garcia, Mario J. / Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate. In: Journal of Cardiovascular Computed Tomography. 2010 ; Vol. 4, No. 3. pp. 197-205.
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T1 - Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate

AU - Carrascosa, Patricia

AU - Capuñay, Carlos

AU - Deviggiano, Alejandro

AU - Goldsmit, Alejandro

AU - Tajer, Carlos

AU - Bettinotti, Marcelo

AU - Carrascosa, Jorge

AU - Ivanc, Thomas B.

AU - Fallahi, Arzhang

AU - Garcia, Mario J.

PY - 2010/5

Y1 - 2010/5

N2 - Background: Desirable methods for cardiac CT angiography would both reduce radiation exposure from cardiac CT angiography and preserve accuracy. Objectives: We assessed image quality, radiation dose, and diagnostic accuracy of a low-dose, prospectively gated axial cardiac CT angiography protocol for the evaluation of patients with suspected coronary artery disease (CAD). Methods: Fifty consecutive patients referred for diagnostic invasive coronary angiography (ICA) and with a stable heart rate < 60 beats/min after β-blocker administration were prospectively enrolled in a single center study. Subjects underwent CT angiography with a 64-row multidetector CT scanner with a prospectively gated axial imaging protocol. If the examination was determined to be nondiagnostic, then a retrospectively gated helical scan was performed. Two reviewers independently assessed image quality and the presence of significant coronary artery stenosis (>50%). Results: Prospectively gated CT angiography was successfully performed in 46 of 50 patients. Of 794 coronary segments, 777 were determined to be of diagnostic image quality. The overall patient-based sensitivity (95% CI), specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of significant coronary stenosis were 100% (87%-100%), 75% (53%-90%), 81% (64%-93%), 100% (81%-100%), and 88% (81%-95%), respectively. The mean effective radiation dose for CT angiography and ICA were 3.4 ± 0.4 mSv and 6.9 ± 0.8 mSv, respectively. Conclusions: Cardiac CT angiography performed in a prospectively gated axial mode with 64-row multidetector CT provides an accurate, low-dose alternative for the detection of CAD.

AB - Background: Desirable methods for cardiac CT angiography would both reduce radiation exposure from cardiac CT angiography and preserve accuracy. Objectives: We assessed image quality, radiation dose, and diagnostic accuracy of a low-dose, prospectively gated axial cardiac CT angiography protocol for the evaluation of patients with suspected coronary artery disease (CAD). Methods: Fifty consecutive patients referred for diagnostic invasive coronary angiography (ICA) and with a stable heart rate < 60 beats/min after β-blocker administration were prospectively enrolled in a single center study. Subjects underwent CT angiography with a 64-row multidetector CT scanner with a prospectively gated axial imaging protocol. If the examination was determined to be nondiagnostic, then a retrospectively gated helical scan was performed. Two reviewers independently assessed image quality and the presence of significant coronary artery stenosis (>50%). Results: Prospectively gated CT angiography was successfully performed in 46 of 50 patients. Of 794 coronary segments, 777 were determined to be of diagnostic image quality. The overall patient-based sensitivity (95% CI), specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of significant coronary stenosis were 100% (87%-100%), 75% (53%-90%), 81% (64%-93%), 100% (81%-100%), and 88% (81%-95%), respectively. The mean effective radiation dose for CT angiography and ICA were 3.4 ± 0.4 mSv and 6.9 ± 0.8 mSv, respectively. Conclusions: Cardiac CT angiography performed in a prospectively gated axial mode with 64-row multidetector CT provides an accurate, low-dose alternative for the detection of CAD.

KW - Computed tomography

KW - Coronary angiography

KW - Coronary artery disease

KW - Prospective ECG triggering

KW - Radiation exposure

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