Imaging of pulmonary vein anatomy using low-dose prospective ECG-triggered dual-source computed tomography.
OBJECTIVE
To prospectively investigate the feasibility, image quality and radiation dose estimates for computed tomography angiography (CTA) of the pulmonary veins and left atrium using prospective electrocardiography (ECG)-triggered sequential dual-source (DS) data acquisition at end-systole in patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation.


METHODS
Thirty-five patients (mean age 66.2 +/- 12.6 years) with paroxysmal atrial fibrillation underwent prospective ECG-triggered sequential DS-CTA with tube current (250 mAs/rotation) centred 250 ms past the R-peak. Tube voltage was adjusted to the BMI (<25 kg/m(2): 100 kV, >25 kg/m(2): 120 kV). Presence of motion or stair-step artefacts was assessed. Effective radiation dose was calculated from the dose-length product.


RESULTS
All data sets could be integrated into the electroanatomical mapping system. Twenty-two patients (63%) were in sinus rhythm (mean heart rate 69.2 +/- 11.1 bpm, variability 1.0 +/- 1.7 bpm) and 13 (37%) showed an ECG pattern of atrial fibrillation (mean heart rate 84.8 +/- 16.6 bpm, variability 17.9 +/- 7.5 bpm). Minor step artefacts were observed in three patients (23%) with atrial fibrillation. Mean estimated effective dose was 1.1 +/- 0.3 and 3.0 +/- 0.5 mSv for 100 and 120 kV respectively.


CONCLUSIONS
Imaging of pulmonary vein anatomy is feasible using prospective ECG-triggered sequential data acquisition at end-systole regardless of heart rate or rhythm at the benefit of low radiation dose.
Blanke
Philipp
P
Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany. philipp.blanke@uniklinik-freiburg.de
Baumann
Tobias
T
Langer
Mathias
M
Pache
Gregor
G
D000368:Aged; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D010690:Phlebography / Q000379:methods*; D011667:Pulmonary Veins / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*