title: Image quality in obese patients undergoing 256-row computed tomography coronary angiography.
abstract: To evaluate, objectively and subjectively, the feasibility of 256-row computed tomography coronary angiography (CTCA) in obese patients. 256-row CTCA was performed in 68 symptomatic patients (age 61 ± 10 years, 37 females), 39 obese (body mass index-BMI > 30 kg/m(2)) and 29 non-obese. Retrospective analysis was performed by two observers who assessed the image quality of each coronary segment using a 4-point subjective scale (1 excellent to 4 non-diagnostic), and another blinded observer measured objective image parameters. BMI in the obese group was 35 ± 5 (32-65) Kg/m(2), and 24 ± 3 (16-29) Kg/m(2) in the non-obese (P = 0.004). Average subjective image quality was similar in obese (1.41 ± 0.40) and non-obese (1.34 ± 0.40) patients, P = 0.17. Proportion of coronary artery segments with non-diagnostic image quality was low in both groups (0.7% in obese and 0.2% in non-obese, P = 0.31). Signal to noise and contrast to noise ratios were not significantly lower in obese than in non-obese patients (9.4 ± 3 vs. 12 ± 2.5, P = 0.16 and 11.1 ± 3.8 vs. 13.7 ± 2.9, P = 0.07 respectively). However, dose length product (1167 ± 567 vs. 827 ± 375 mGy × cm, P = 0.014) and image noise (44 ± 13 vs. 35 ± 5 HU, P < 0.001) were higher in the obese patient group. Image quality was preserved in obese patients undergoing 256-row CTCA at the cost of increased radiation exposure and image noise.
authors.affiliation: Department of Radiology, Lady Davis Carmel Medical Center, Haifa, Israel.
authors.forename: Orit Lesman
authors.initials: OL
authors.lastname: Segev
authors.forename: Tamar
authors.initials: T
authors.lastname: Gaspar
authors.forename: David A
authors.initials: DA
authors.lastname: Halon
authors.forename: Nathan
authors.initials: N
authors.lastname: Peled
authors.forename: Liran
authors.initials: L
authors.lastname: Domachevsky
authors.forename: Basil S
authors.initials: BS
authors.lastname: Lewis
authors.forename: Ronen
authors.initials: R
authors.lastname: Rubinshtein
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed