title: Dual-source coronary CT angiography in patients with high heart rates using a prospectively ECG-triggered axial mode at end-systole.
abstract: To determine the feasibility of dual-source coronary CT angiography (CTA) using a prospectively electrocardiogram (ECG)-triggered axial mode to target end-systole in patients with high heart rates (HR) as compared with the retrospective mode. One hundred fifty consecutive patients with regular HR > 75 bpm who underwent coronary CTA were enrolled; 75 patients underwent prospectively ECG-triggered coronary CTA targeting only end-systole (Prospective Axial Group) and 75 patients underwent retrospectively ECG-gated coronary CTA (Retrospective Helical Group). The image quality of multiple coronary artery segments was evaluated and radiation doses were recorded. The diagnostic performance of coronary CTA was compared to the reference standard of invasive coronary angiography in 52 patients (35 %) (28 patients in Prospective Axial Group and 24 patients in Retrospective Helical Group). Image quality was not significantly different between the 2 groups (P = 0.784). In subgroup analysis, segment-based sensitivity, specificity, and positive and negative predictive values of coronary CTA were 98, 96, 88 and 99 %, respectively, in the Prospective Axial Group and were 97, 95, 82, and 99 %, respectively, in the Retrospective Helical Group. Mean radiation dose was significantly lower for the Prospective Axial Group than for the Retrospective Helical Group (2.9 ± 1.4 vs. 7.4 ± 3.3 mSv; P < 0.0001). Dual source coronary CTA with a prospective ECG-triggered axial mode targeting end-systole is feasible in patients with regular high HRs for evaluation of coronary artery disease. It provides comparable image quality and diagnostic value with substantially lower radiation exposure as compared to the retrospective ECG-gated helical technique.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
authors.forename: Hee Yeong
authors.initials: HY
authors.lastname: Kim
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Nam
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods* / Q000592:standards; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods* / Q000592:standards; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D012015:Reference Standards; D012680:Sensitivity and Specificity; D013599:Systole; D036542:Tomography, Spiral Computed / Q000592:standards