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European Radiology
Published in: European Radiology 5/2018

Open Access 01-05-2018 | Cardiac

Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment

Authors: Marguerite E. Faure, Laurens E. Swart, Marcel L. Dijkshoorn, Jos A. Bekkers, Marcel van Straten, Koen Nieman, Paul M. Parizel, Gabriel P. Krestin, Ricardo P. J. Budde

Published in: European Radiology | Issue 5/2018

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Abstract

Objectives

Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose.

Methods

Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP).

Results

We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43).

Conclusion

Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose.

Key points

• Prosthetic heart valve dysfunction is a potentially life-threatening condition.
• Dual-source CT can adequately assess valve leaflet motion and anatomy.
• We assessed a comprehensive protocol with three acquisitions for PHV evaluation.
• This protocol is associated with good image quality and limited dose.
Literature
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Metadata
Title
Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
Authors
Marguerite E. Faure
Laurens E. Swart
Marcel L. Dijkshoorn
Jos A. Bekkers
Marcel van Straten
Koen Nieman
Paul M. Parizel
Gabriel P. Krestin
Ricardo P. J. Budde
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5163-7

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