title: Multidetector computed tomography for coronary stents imaging: high-voltage (140-kVp) prospective ECG-triggered versus standard-voltage (120-kVp) retrospective ECG-gated helical scanning.
abstract: OBJECTIVE
  To compare prospective electrocardiogram (ECG)-triggered high-voltage coronary computed tomography (CT) angiography (CTA; 140-kVp P-cCTA) with retrospective ECG-gated standard-voltage cCTA (120-kVp R-cCTA), in patients with coronary stents.
  
  
  METHODS
  Fifty-two patients with coronary stents were studied with 64-slice multidetector scanner. Ninety-three stents were analyzed: 55 with 140-kVp P-cCTA and 38 with 120-kVp R-cCTA. Image quality (IQ), diagnostic confidence (DC), in-stent assessable lumen, artificial narrowing, and effective radiation dose were compared between techniques.
  
  
  RESULTS
  Image quality and DC were significantly better for the 140-kVp P-cCTA in comparison with the 120-kVp R-cCTA (IQ, 1.1 ± 0.36 vs 1.7 ± 0.60, respectively; P < 0.00001. Diagnostic confidence: 1.1 ± 0.29 vs 1.5 ± 0.65 respectively; P < 0.0001). In-stent assessable lumen and artificial narrowing were comparable between the techniques. Effective dose was lower for the 140-kVp P-cCTA (6.7 ± 2.07 mSv vs 15.8 ± 6.89 mSv; P < 0.0001).
  
  
  CONCLUSIONS
  High voltage combined with axial prospective ECG-triggered scan improved IQ and DC in stent cCTA imaging but failed to improve the diameter of in-stent assessable lumen and to reduce the artificial narrowing compared with the 120-kVp R-cCTA. Effective dose was 60% lower for the 140-kVp P-cCTA.
authors.affiliation: Department of Radiology and Experimental Imaging Center, San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy. esposito.antonio@hsr.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Esposito
authors.forename: Caterina
authors.initials: C
authors.lastname: Colantoni
authors.forename: Francesco
authors.initials: F
authors.lastname: De Cobelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Del Vecchio
authors.forename: Anna
authors.initials: A
authors.lastname: Palmisano
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calandrino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Maschio
mesh_terms: D000368:Aged; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents