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01-03-2013 | Computed Tomography

Diagnostic accuracy of 128-slice dual-source CT coronary angiography: a randomized comparison of different acquisition protocols

Authors: Lisan A. Neefjes, Alexia Rossi, Tessa S. S. Genders, Koen Nieman, Stella L. Papadopoulou, Anoeshka S. Dharampal, Carl J. Schultz, Annick C. Weustink, Marcel L. Dijkshoorn, Gert-Jan R. ten Kate, Admir Dedic, Marcel van Straten, Filippo Cademartiri, M. G. Myriam Hunink, Gabriël P. Krestin, Pim J. de Feyter, Nico R. Mollet

Published in: European Radiology | Issue 3/2013

Abstract

Objectives

To compare the diagnostic performance and radiation exposure of 128-slice dual-source CT coronary angiography (CTCA) protocols to detect coronary stenosis with more than 50 % lumen obstruction.

Methods

We prospectively included 459 symptomatic patients referred for CTCA. Patients were randomized between high-pitch spiral vs. narrow-window sequential CTCA protocols (heart rate below 65 bpm, group A), or between wide-window sequential vs. retrospective spiral protocols (heart rate above 65 bpm, group B). Diagnostic performance of CTCA was compared with quantitative coronary angiography in 267 patients.

Results

In group A (231 patients, 146 men, mean heart rate 58 ± 7 bpm), high-pitch spiral CTCA yielded a lower per-segment sensitivity compared to sequential CTCA (89 % vs. 97 %, P = 0.01). Specificity, PPV and NPV were comparable (95 %, 62 %, 99 % vs. 96 %, 73 %, 100 %, P > 0.05) but radiation dose was lower (1.16 ± 0.60 vs. 3.82 ± 1.65 mSv, P < 0.001). In group B (228 patients, 132 men, mean heart rate 75 ± 11 bpm), per-segment sensitivity, specificity, PPV and NPV were comparable (94 %, 95 %, 67 %, 99 % vs. 92 %, 95 %, 66 %, 99 %, P > 0.05). Radiation dose of sequential CTCA was lower compared to retrospective CTCA (6.12 ± 2.58 vs. 8.13 ± 4.52 mSv, P < 0.001). Diagnostic performance was comparable in both groups.

Conclusion

Sequential CTCA should be used in patients with regular heart rates using 128-slice dual-source CT, providing optimal diagnostic accuracy with as low as reasonably achievable (ALARA) radiation dose.

Key Points

• 128-slice dual-source CT coronary angiography offers several different acquisition protocols.

• Randomized comparison of protocols reveals an optimal protocol selection strategy.

• Appropriate CTCA protocol selection lowers radiation dose, while maintaining high quality.

• CTCA protocol selection should be based on individual patient characteristics.

• A prospective sequential protocol is preferred for CTCA.

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Title: Diagnostic accuracy of 128-slice dual-source CT coronary angiography: a randomized comparison of different acquisition protocols
Authors: Lisan A. Neefjes
Alexia Rossi
Tessa S. S. Genders
Koen Nieman
Stella L. Papadopoulou
Anoeshka S. Dharampal
Carl J. Schultz
Annick C. Weustink
Marcel L. Dijkshoorn
Gert-Jan R. ten Kate
Admir Dedic
Marcel van Straten
Filippo Cademartiri
M. G. Myriam Hunink
Gabriël P. Krestin
Pim J. de Feyter
Nico R. Mollet
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 3/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2663-3

ACC 2024 Congress

Springer Medicine

Diagnostic accuracy of 128-slice dual-source CT coronary angiography: a randomized comparison of different acquisition protocols

Abstract

Objectives

Methods

Results

Conclusion

Key Points

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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