title: Gender influence on dose saving allowed by prospective-triggered 64-slice multidetector computed tomography coronary angiography as compared with retrospective-gated mode.
abstract: OBJECTIVE
  To assess the gender influence on radiation dose saving allowed by prospective ECG-triggered MDCT coronary angiography (P-MDCT-CA) in comparison with retrospective ECG-gated MDCT-CA (R-MDCT-CA). The influence of kilovoltage and body mass index on radiation dose and the impact of different parameters on image quality (IQ) and diagnostic confidence (DC), were also determined.
  
  
  METHODS
  64-slice MDCT-CA was performed in 176 patients: 66 R-MDCT-CA and 110 P-MDCT-CA. Effective dose was determined using ImpactDose software based on Monte Carlo method. Three point scales were used to assess IQ and DC on a segmental basis.
  
  
  RESULTS
  Patients were divided into 4 groups according with the examination performed: group A (90 pts, coronary tree assessment with P-MDCT-CA); group B (55 pts, coronary tree assessment with R-MDCT-CA); group C (20 pts, bypass grafts assessment with P-MDCT-CA); and group D (11 pts, bypass grafts assessment with R-MDCT-CA). Effective dose was 68% lower for P-MDCT-CA than R-MDCT-CA for coronary artery studies (Gr. A=4.7 ± 1.69 mSv and Gr. B=14.9 ± 4.4 mSv; p<0.05) and 63% lower for by-pass studies. Effective dose resulted significantly higher in women than in men who underwent R-MDCT-CA; conversely, no gender impact was observed on effective dose of P-MDCT-CA. As a result, dose saving with prospective gating was more pronounced in women (73%; R-MDCT-CA:16.3 mSv, P-MDCT-CA:4.5 mSv,) than in men (60%; R-MDCT-CA:12.8 mSv, P-MDCT-CA:4.8 mSv). IQ and DC of P-MDCT-CA were better or comparable than R-MDCT-CA CONCLUSIONS: P-MDCT-CA provides at least comparable IQ and DC than R-MDCT-CA with significant dose saving. This study highlights the important advantage offered by using P-MDCT-CA in female patients.
authors.affiliation: Department of Radiology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. esposito.antonio@hsr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Esposito
authors.forename: Francesco
authors.initials: F
authors.lastname: De Cobelli
authors.forename: Caterina
authors.initials: C
authors.lastname: Colantoni
authors.forename: Gianluca
authors.initials: G
authors.lastname: Perseghin
authors.forename: Antonella
authors.initials: A
authors.lastname: Del Vecchio
authors.forename: Tamara
authors.initials: T
authors.lastname: Canu
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calandrino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D012189:Retrospective Studies; D012737:Sex Factors