title: A New Contrast Enhancement Protocol for Subtraction Coronary Computed Tomography Requiring a Short Breath-Holding Time.
abstract: We have developed a new contrast enhancement protocol for subtraction coronary computed tomography (SCCTA) requiring a short breath-holding time. In the protocol, test and main boluses were sequentially and automatically injected, and correct timings for pre-contrast and contrast-enhanced scans for main bolus were automatically determined only by the test bolus tracking. Combined with a fixed short main bolus injection for 7 seconds, the breath-holding time was shortened as possible. The purpose of this study was to evaluate whether use of this new protocol produced adequate quality images, taking into account calcified lesions and in-stent lumens.
  
  
  
  Patients (n = 127) with calcium scores of >400 Agatston units or a history of stent placement were enrolled. Breath-holding times were recorded, and image quality was visually evaluated by two observers.
  
  
  
  The mean ± standard deviation breath-holding time was 13.2 ± 0.6 seconds. The mean ± SD computed tomography (CT) number of coronary arteries for the pre-contrast scan was sufficiently low [99.2 ± 32.2 Hounsfield units (HU)] and, simultaneously, that for SCCTA was 367.0 ± 77.2 HU. The rate of segments evaluated as unreadable was sufficiently low (3.8%).
  
  
  
  Use of the SCCTA protocol was efficient and allowed for a shorter breath-holding time and adequate diagnostic accuracy of SCCTA images, including images of calcified and stent implantation segments.
authors.affiliation: Department of Radiological Technology, Japan Community Health care Organization Hokkaido Hospital, 3-18 Nakanoshima 1-Jo 8-Chome, Toyohira-Ku, Sapporo, Hokkaido 062-8618, Japan; Graduate School of Medical Science, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan. Electronic address: yamataka@eagle.ocn.ne.jp.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Ichikawa
authors.affiliation: Department of Radiological Technology, Japan Community Health care Organization Hokkaido Hospital, 3-18 Nakanoshima 1-Jo 8-Chome, Toyohira-Ku, Sapporo, Hokkaido 062-8618, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Takahashi
authors.affiliation: Cardiovascular Center, Japan Community Health care Organization Hokkaido Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Sugaya
authors.affiliation: Cardiovascular Center, Japan Community Health care Organization Hokkaido Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Jungo
authors.initials: J
authors.lastname: Furuya
authors.affiliation: Cardiovascular Center, Japan Community Health care Organization Hokkaido Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Igarashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062485:Breath Holding; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015607:Stents; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Test bolus tracking method; coronary calcification; coronary stent implantation; short breath-holding time; subtraction coronary CTA