Top

Published in:

01-05-2017 | Cardiac

CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

Authors: Shunsuke Matsumoto, Yoshitake Yamada, Masahiro Hashimoto, Teppei Okamura, Minoru Yamada, Fumiaki Yashima, Kentaro Hayashida, Keiichi Fukuda, Masahiro Jinzaki

Published in: European Radiology | Issue 5/2017

Abstract

Objectives

To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD).

Methods

Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time × weight [kg] × 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard.

Results

The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV).

Conclusions

CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD.

Key Points

• TAVI-planning CT using variable helical pitch (VHP) scanning is useful.

• The average volume of contrast material was 38.7 ± 8.5 mL.

• The average attenuations of all the arteries were >400 HU.

• This CT had a high sensitivity and NPV for excluding obstructive CAD.

Webb JG, Wood DA (2012) Current status of transcatheter aortic valve replacement. J Am Coll Cardiol 60:483–492CrossRefPubMed

Leon MB, Smith CR, Mack M et al (2010) Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 363:1597–1607CrossRefPubMed

Smith CR, Leon MB, Mack MJ et al (2011) Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 364:2187–2198CrossRefPubMed

Achenbach S, Delgado V, Hausleiter J, Schoenhagen P, Min JK, Leipsic JA (2012) SCCT expert consensus document on computed tomography imaging before transcatheter aortic valve implantation (TAVI)/transcatheter aortic valve replacement (TAVR). J Cardiovasc Comput Tomogr 6:366–380CrossRefPubMed

Yamamoto M, Hayashida K, Mouillet G et al (2013) Prognostic value of chronic kidney disease after transcatheter aortic valve implantation. J Am Coll Cardiol 62:869–877CrossRefPubMed

Yamamoto M, Hayashida K, Mouillet G et al (2013) Renal function-based contrast dosing predicts acute kidney injury following transcatheter aortic valve implantation. JACC Cardiovasc Interv 6:479–486CrossRefPubMed

Goel SS, Ige M, Tuzcu EM et al (2013) Severe aortic stenosis and coronary artery disease--implications for management in the transcatheter aortic valve replacement era: a comprehensive review. J Am Coll Cardiol 62:1–10CrossRefPubMed

Harris BS, De Cecco CN, Schoepf UJ et al (2015) Dual-source CT imaging to plan transcatheter aortic valve replacement: accuracy for diagnosis of obstructive coronary artery disease. Radiology 275:80–88CrossRefPubMed

Toggweiler S (2014) How to reduce costs in transcatheter aortic valve implantation. Open Heart 1:e000203CrossRefPubMedPubMedCentral

10.

Yamada Y, Jinzaki M, Hosokawa T et al (2012) Dose reduction in chest CT: comparison of the adaptive iterative dose reduction 3D, adaptive iterative dose reduction, and filtered back projection reconstruction techniques. Eur J Radiol 81:4185–4195CrossRefPubMed

11.

Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRefPubMed

12.

McCollough C, Cody D, Edyvean S et al (2008) The measurement, reporting, and management of radiation dose in CT. Rep AAPM Task Group 23:1–28

13.

Fei X, Du X, Yang Q et al (2008) 64-MDCT coronary angiography: phantom study of effects of vascular attenuation on detection of coronary stenosis. AJR Am J Roentgenol 191:43–49CrossRefPubMed

14.

Hausleiter J, Meyer TS, Martuscelli E et al (2012) Image quality and radiation exposure with prospectively ECG-triggered axial scanning for coronary CT angiography: the multicenter, multivendor, randomized PROTECTION-III study. JACC Cardiovasc Imaging 5:484–493CrossRefPubMed

15.

Cademartiri F, Maffei E, Palumbo AA et al (2008) Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography. Eur Radiol 18:576–583CrossRefPubMed

16.

Azzalini L, Abbara S, Ghoshhajra BB (2014) Ultra-low contrast computed tomographic angiography (CTA) with 20-mL total dose for transcatheter aortic valve implantation (TAVI) planning. J Comput Assist Tomogr 38:105–109CrossRefPubMed

17.

Wuest W, Anders K, Schuhbaeck A et al (2012) Dual source multidetector CT-angiography before Transcatheter Aortic Valve Implantation (TAVI) using a high-pitch spiral acquisition mode. Eur Radiol 22:51–58CrossRefPubMed

18.

Toggweiler S, Gurvitch R, Leipsic J et al (2012) Percutaneous aortic valve replacement: vascular outcomes with a fully percutaneous procedure. J Am Coll Cardiol 59:113–118CrossRefPubMed

19.

Rodes-Cabau J, Webb JG, Cheung A et al (2010) Transcatheter aortic valve implantation for the treatment of severe symptomatic aortic stenosis in patients at very high or prohibitive surgical risk: acute and late outcomes of the multicenter Canadian experience. J Am Coll Cardiol 55:1080–1090CrossRefPubMed

20.

Kok M, Turek J, Mihl C et al (2015) Low contrast media volume in pre-TAVI CT examinations. Eur Radiol 1–10

21.

Dubourg B, Caudron J, Lestrat J-P et al (2014) Single-source dual-energy CT angiography with reduced iodine load in patients referred for aortoiliofemoral evaluation before transcatheter aortic valve implantation: impact on image quality and radiation dose. Eur Radiol 24:2659–2668CrossRefPubMed

22.

Staab W, Bergau L, Lotz J, Sohns C (2014) Prevalence of noncardiac findings in computed tomography angiography before transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr 8:222–229CrossRefPubMed

Title: CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease
Authors: Shunsuke Matsumoto
Yoshitake Yamada
Masahiro Hashimoto
Teppei Okamura
Minoru Yamada
Fumiaki Yashima
Kentaro Hayashida
Keiichi Fukuda
Masahiro Jinzaki
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4547-4

At a glance: The STEP trials

Springer Medicine

CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 5/2017

Non-invasive quantification of tumour heterogeneity in water diffusivity to differentiate malignant from benign tissues of urinary bladder: a phase I study

Volume-based quantification using dual-energy computed tomography in the differentiation of thymic epithelial tumours: an initial experience

Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology

Diagnostic accuracy of DXA compared to conventional spine radiographs for the detection of vertebral fractures in children

Cadaver-specific CT scans visualized at the dissection table combined with virtual dissection tables improve learning performance in general gross anatomy

Stiffness of benign and malignant prostate tissue measured by shear-wave elastography: a preliminary study