Radiation dose, image quality, stenosis measurement, and CT densitometry using ECG-triggered coronary 64-MDCT angiography: a phantom study.
OBJECTIVE
The purpose of this study was to compare prospective ECG-triggered and retrospective ECG-gated coronary 64-MDCT angiography as to radiation dose, image quality, accuracy of stenosis measurement, and CT densitometry.


METHODS
Coronary artery models (n = 3) with different plaque densities (approximately 50, approximately 110, and approximately 1,000 H) on a cardiac phantom were scanned in variable heart rate sequences (n = 14) with both prospective ECG-triggered and retrospective ECG-gated scanning. Radiation dose, image quality graded by motion and stairstep artifacts (grade 1, excellent, to grade 4, poor, with grades 1 and 2 defined as satisfactory), accuracy of stenosis measurement (area; 18%, 50%, and 82%), and CT densitometry of plaques (soft, approximately 50; and intermediate, approximately 110 H) were compared between the two protocols using the Mann-Whitney U test and repeated measures.


RESULTS
The radiation dose of prospective ECG-triggered CT angiography (CTA) (3.0 mSv) was lower than that of retrospective ECG-gated CTA (11.7-13.0 mSv) when the same tube current (mA) and voltage (kVp) were used in both methods. Prospective ECG-triggered CTA images were assigned a satisfactory quality rating in stable heart rate up to 75 beats per minute (bpm) when using the minimal X-ray exposure time. In this range, there were no significant differences in stenosis measurement (p = 0.17) and CT densitometry (p = 0.93) between the two protocols.


CONCLUSIONS
Prospective ECG-triggered coronary 64-MDCT has the potential to reduce radiation exposure while maintaining the diagnostic performance of retrospective ECG-gated coronary 64-MDCT.
Horiguchi
Jun
J
Department of Clinical Radiology, Hiroshima University Hospital, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan. horiguch@hiroshima-u.ac.jp
Kiguchi
Masao
M
Fujioka
Chikako
C
Shen
Yun
Y
Arie
Ryuichi
R
Sunasaka
Kenichi
K
Ito
Katsuhide
K
D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*