title: Multi-detector row CT: is prospective electrocardiographic triggering improving the detection of small pulmonary tumors?
abstract: OBJECTIVE
  To compare prospectively ECG-triggered multi-detector row computed tomography (ECG-MDR-CT) and multi-detector row computed tomography (MDR-CT) without triggering for the detection of pulmonary tumors.
  
  
  METHODS
  100 patients with proven or suspected tumors were referred for CT of the lung for staging of lung metastases. First, a non-enhanced scan was performed using prospective ECG-triggering on a four-row multidetector helical CT scanner, followed by a contrast-enhanced scan without triggering. The diagnostic assessibility in detecting intrapulmonary nodules and mediastinal structures was graded using a 5-point scale (rated 1 = bad to 5 = very good image quality).
  
  
  RESULTS
  ECG-MDR-CT images detected a total of 26% more pulmonary nodules than MDR-CT. For tumors <5 mm, the detection rate was 62% higher using ECG-triggered scans (P = .024). Subjective assessment found median demarcation ratings for all pulmonary findings of 4 (ECG-MDR-CT) versus 3 (MDR-CT). Mediastinal structures were delineated better using ECG triggering. The median ranking for demarcation of pulmonary findings <10 mm was 4 on ECG-MDR-CT and 3 on MDR-CT, respectively. For vessels and the left bronchus, the median of demarcation was 4 on triggered images and 2 on MDR-CT, respectively. The median values referring to the demarcation of mediastinal structures were not significantly different between ECG-MDR-CT and MDR-CT.
  
  
  CONCLUSIONS
  Our data indicate the superiority of prospectively triggered ECG-MDR-CT over MDR-CT for the diagnosis of small pulmonary tumors using a 4-row multidetector CT.
authors.affiliation: Department of Diagnostic Radiology, University of Ulm, Steinhoevelstr. 9, 89075 Ulm, Germany. sandra.pauls@medizin.uni-ulm.de
authors.forename: Sandra
authors.initials: S
authors.lastname: Pauls
authors.forename: Andrik J
authors.initials: AJ
authors.lastname: Aschoff
authors.forename: Juliane
authors.initials: J
authors.lastname: Wahl
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Brambs
authors.forename: Thorsten R
authors.initials: TR
authors.lastname: Fleiter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D036542:Tomography, Spiral Computed / Q000379:methods*