Angiografìa coronaria por tomografìa computarizada multidetector con gatillado electrocardiográfico prospectivo. Análisis de la calidad de imagen y de la dosis de radiación

Translated title of the contribution: Prospective electrocardiogram-gated multidetector row computed tomography coronary angiography: Analysis of quality image and radiation dose

Patricia Carrascosa, Carlos Capuñay, Alejandro Deviggiano, Carlos D. Tajer, Javier Vallejos, Alejandro Goldsmit, Mario J. Garcia

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Multidetector row computed tomography coronary angiography (MDCT-CA) has become a useful diagnostic tool for the direct quantification of coronary stenosis, for identifying coronary anomalies and for the assessment of coronary artery bypass grafts. Despite its clinical value has been questioned due to the effective radiation dose (ERD) received by each patient, radiation exposure is similar to other studies. However, different strategies are permanently tested in order to reduce the ERD maintaining adequate and diagnostic image quality. Objectives: To determine the image quality and effective radiation dose (ERD) of prospective electrocardiogram-gated multidetector row computed tomography coronary angiography (PMDCT-CA) (the x-ray beam is turned on for only a short portion of diastole) compared to retrospective ECG gating (RMDCT-CA) (the x-ray beam is turned on throughout the cardiac cycle) and a preliminary approach of its diagnostic accuracy compared to digital invasive coronary angiography (CA). Material and Methods: Fifty consecutive patients with suspected coronary artery disease and sinus rhythm were evaluated with PMDCT-CA and compared to a control group who underwent RMDCT-CA. Image quality was analyzed by two reviewers. Interobserver concordance and ERD were determined. The diagnostic accuracy of PMDCT-CA compared to CA to detect coronary artery stenosis > 50% was assessed in 30 patients. Results: There were no significant differences in the image quality between both groups. Agreement between the reviewers for segment image quality scores was k = 0.92. Mean ERD was 3.5 mSv for PMDCT-CA compared to 9.7 and 12.9 mSv for RMDCT-CA with and without tube current modulation, respectively. Individual analysis including all segments showed that the sensitivity, specificity, positive predictive value and negative predictive value of PMDCT-CA for the detection of coronary stenosis were 94.74%, 81.82%, 90% and 90%, respectively. Conclusion: Our initial experience demonstrated that PMDCT-CA has similar subjective image quality scores with a substantial reduction of ERD when compared to RMDCT-CA in a selected population.

Original languageSpanish
Pages (from-to)259-267
Number of pages9
JournalRevista Argentina de Cardiologia
Volume77
Issue number4
StatePublished - Jul 2009
Externally publishedYes

Fingerprint

Multidetector Computed Tomography
Coronary Angiography
Electrocardiography
Radiation
Coronary Stenosis
Computed Tomography Angiography
X-Rays
Diastole
Coronary Sinus
Coronary Artery Bypass
Coronary Artery Disease

Keywords

  • Coronary angiography
  • Coronary stenosis
  • Radiation dosage
  • Tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Angiografìa coronaria por tomografìa computarizada multidetector con gatillado electrocardiográfico prospectivo. Análisis de la calidad de imagen y de la dosis de radiación. / Carrascosa, Patricia; Capuñay, Carlos; Deviggiano, Alejandro; Tajer, Carlos D.; Vallejos, Javier; Goldsmit, Alejandro; Garcia, Mario J.

In: Revista Argentina de Cardiologia, Vol. 77, No. 4, 07.2009, p. 259-267.

Research output: Contribution to journalArticle

Carrascosa, Patricia ; Capuñay, Carlos ; Deviggiano, Alejandro ; Tajer, Carlos D. ; Vallejos, Javier ; Goldsmit, Alejandro ; Garcia, Mario J. / Angiografìa coronaria por tomografìa computarizada multidetector con gatillado electrocardiográfico prospectivo. Análisis de la calidad de imagen y de la dosis de radiación. In: Revista Argentina de Cardiologia. 2009 ; Vol. 77, No. 4. pp. 259-267.
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abstract = "Background: Multidetector row computed tomography coronary angiography (MDCT-CA) has become a useful diagnostic tool for the direct quantification of coronary stenosis, for identifying coronary anomalies and for the assessment of coronary artery bypass grafts. Despite its clinical value has been questioned due to the effective radiation dose (ERD) received by each patient, radiation exposure is similar to other studies. However, different strategies are permanently tested in order to reduce the ERD maintaining adequate and diagnostic image quality. Objectives: To determine the image quality and effective radiation dose (ERD) of prospective electrocardiogram-gated multidetector row computed tomography coronary angiography (PMDCT-CA) (the x-ray beam is turned on for only a short portion of diastole) compared to retrospective ECG gating (RMDCT-CA) (the x-ray beam is turned on throughout the cardiac cycle) and a preliminary approach of its diagnostic accuracy compared to digital invasive coronary angiography (CA). Material and Methods: Fifty consecutive patients with suspected coronary artery disease and sinus rhythm were evaluated with PMDCT-CA and compared to a control group who underwent RMDCT-CA. Image quality was analyzed by two reviewers. Interobserver concordance and ERD were determined. The diagnostic accuracy of PMDCT-CA compared to CA to detect coronary artery stenosis > 50{\%} was assessed in 30 patients. Results: There were no significant differences in the image quality between both groups. Agreement between the reviewers for segment image quality scores was k = 0.92. Mean ERD was 3.5 mSv for PMDCT-CA compared to 9.7 and 12.9 mSv for RMDCT-CA with and without tube current modulation, respectively. Individual analysis including all segments showed that the sensitivity, specificity, positive predictive value and negative predictive value of PMDCT-CA for the detection of coronary stenosis were 94.74{\%}, 81.82{\%}, 90{\%} and 90{\%}, respectively. Conclusion: Our initial experience demonstrated that PMDCT-CA has similar subjective image quality scores with a substantial reduction of ERD when compared to RMDCT-CA in a selected population.",
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AU - Capuñay, Carlos

AU - Deviggiano, Alejandro

AU - Tajer, Carlos D.

AU - Vallejos, Javier

AU - Goldsmit, Alejandro

AU - Garcia, Mario J.

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AB - Background: Multidetector row computed tomography coronary angiography (MDCT-CA) has become a useful diagnostic tool for the direct quantification of coronary stenosis, for identifying coronary anomalies and for the assessment of coronary artery bypass grafts. Despite its clinical value has been questioned due to the effective radiation dose (ERD) received by each patient, radiation exposure is similar to other studies. However, different strategies are permanently tested in order to reduce the ERD maintaining adequate and diagnostic image quality. Objectives: To determine the image quality and effective radiation dose (ERD) of prospective electrocardiogram-gated multidetector row computed tomography coronary angiography (PMDCT-CA) (the x-ray beam is turned on for only a short portion of diastole) compared to retrospective ECG gating (RMDCT-CA) (the x-ray beam is turned on throughout the cardiac cycle) and a preliminary approach of its diagnostic accuracy compared to digital invasive coronary angiography (CA). Material and Methods: Fifty consecutive patients with suspected coronary artery disease and sinus rhythm were evaluated with PMDCT-CA and compared to a control group who underwent RMDCT-CA. Image quality was analyzed by two reviewers. Interobserver concordance and ERD were determined. The diagnostic accuracy of PMDCT-CA compared to CA to detect coronary artery stenosis > 50% was assessed in 30 patients. Results: There were no significant differences in the image quality between both groups. Agreement between the reviewers for segment image quality scores was k = 0.92. Mean ERD was 3.5 mSv for PMDCT-CA compared to 9.7 and 12.9 mSv for RMDCT-CA with and without tube current modulation, respectively. Individual analysis including all segments showed that the sensitivity, specificity, positive predictive value and negative predictive value of PMDCT-CA for the detection of coronary stenosis were 94.74%, 81.82%, 90% and 90%, respectively. Conclusion: Our initial experience demonstrated that PMDCT-CA has similar subjective image quality scores with a substantial reduction of ERD when compared to RMDCT-CA in a selected population.

KW - Coronary angiography

KW - Coronary stenosis

KW - Radiation dosage

KW - Tomography

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