title: The diagnostic accuracy, image quality and radiation dose of 64-slice dual-source CT in daily practice: a single institution's experience.
abstract: OBJECTIVE
  We wanted to evaluate the image quality, diagnostic accuracy and radiation exposure of 64-slice dual-source CT (DSCT) coronary angiography according to the heart rate in symptomatic patients during daily clinical practice.
  
  
  METHODS
  We performed a retrospective search for the DSCT coronary angiography reports of 729 consecutive symptomatic patients. For the 131 patients who underwent invasive coronary angiography, the image quality, the diagnostic performance (sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] for detecting significant stenosis ≥ 50% diameter) and the radiation exposure were evaluated. These values were compared between the groups with differing heart rates (HR): mean HR < 65 or ≥ 65 and HR variability (HRV) < 15 or ≥ 15.
  
  
  RESULTS
  Among the 729 patients, the CT reports showed no stenosis or insignificant coronary artery stenosis in 72%, significant stenosis in 26% and non-diagnostic in 2%. For the 131 patients who underwent invasive coronary angiography, 95% of the patients and 97% of the segments were evaluable, and the overall per-patient/per-segment sensitivity, the perpatient/per-segment specificity, the per-patient/per-segment PPV and the per-patient/per-segment NPV were 100%/90%, 71%/98%, 95%/88% and 100%/97%, respectively. The image quality was better in the HR < 65 group than in the HR ≥ 65 group (p = 0.001), but there was no difference in diagnostic performance between the two groups. The mean effective radiation doses were lower in the HR < 65 or HRV < 15 group (p < 0.0001): 5.5 versus 6.7 mSv for the mean HR groups and 5.3 versus 9.3 mSv for the HRV groups.
  
  
  CONCLUSIONS
  Dual-source CT coronary angiography is a highly accurate modality in the clinical setting. Better image quality and a significant radiation reduction are being rendered in the lower HR group.
authors: Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul 110-744, Korea.
authors: Joon Ho
authors: JH
authors: Moon
authors: Eun-Ah
authors: EA
authors: Park
authors: Whal
authors: W
authors: Lee
authors: Yong Hu
authors: YH
authors: Yin
authors: Jin Wook
authors: JW
authors: Chung
authors: Jae Hyung
authors: JH
authors: Park
authors: Hae-Young
authors: HY
authors: Lee
authors: Hyun-Jae
authors: HJ
authors: Kang
authors: Hyo-Soo
authors: HS
authors: Kim
references: Eur Radiol. 2006 Jul;16(7):1409-15
references: 16770652
references: Int J Cardiovasc Imaging. 2010 Mar;26(3):323-31
references: 19888670
references: Eur Radiol. 2008 Mar;18(3):592-9
references: 17909816
references: Radiology. 2008 May;247(2):346-55
references: 18372455
references: Radiology. 2007 Dec;245(3):720-31
references: 17951354
references: Radiology. 2007 Jun;243(3):775-84
references: 17446525
references: J Am Coll Cardiol. 2007 Dec 18;50(25):2393-8
references: 18154964
references: Circ J. 2009 Feb;73(2):316-22
references: 19122307
references: Eur Radiol. 2006 Feb;16(2):256-68
references: 16341833
references: Eur J Radiol. 2006 Mar;57(3):331-5
references: 16426789
references: Am J Cardiol. 2007 Aug 15;100(4):587-92
references: 17697811
references: Eur Heart J. 2007 Oct;28(19):2354-60
references: 17644815
references: J Cardiovasc Comput Tomogr. 2007 Dec;1(3):143-51
references: 19083898
references: Invest Radiol. 2007 Oct;42(10):684-91
references: 17984765
references: Korean J Radiol. 2009 Jul-Aug;10(4):347-54
references: 19568462
references: Radiology. 2009 Dec;253(3):672-80
references: 19864512
references: Eur Radiol. 2006 Dec;16(12):2739-47
references: 17031451
references: Radiology. 2007 Dec;245(3):703-11
references: 18024451
references: AJR Am J Roentgenol. 2009 Apr;192(4):1051-6
references: 19304713
references: Radiology. 1999 Dec;213(3):751-8
references: 10580949
references: Circulation. 1975 Apr;51(4 Suppl):5-40
references: 1116248
references: Radiology. 2009 Aug;252(2):377-85
references: 19546426
references: Eur J Radiol. 2010 Apr;74(1):161-5
references: 19261419
references: Eur Radiol. 2009 Mar;19(3):584-90
references: 18953544
references: Radiology. 2008 Sep;248(3):792-8
references: 18710975