Comparison of radiation dose and image quality of triple-rule-out computed tomography angiography between conventional helical scanning and a strategy incorporating sequential scanning.

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  • Additional Information
    • Source:
      Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : Excerpta Medica
    • Subject Terms:
    • Abstract:
      Triple-rule-out computed tomographic angiography (TRO CTA), performed to evaluate the coronary arteries, pulmonary arteries, and thoracic aorta, has been associated with high radiation exposure. The use of sequential scanning for coronary computed tomographic angiography reduces the radiation dose. The application of sequential scanning to TRO CTA is much less well defined. We analyzed the radiation dose and image quality from TRO CTA performed at a single outpatient center, comparing the scans from a period during which helical scanning with electrocardiographically controlled tube current modulation was used for all patients (n = 35) and after adoption of a strategy incorporating sequential scanning whenever appropriate (n = 35). Sequential scanning was able to be used for 86% of the cases. The sequential-if-appropriate strategy, compared to the helical-only strategy, was associated with a 61.6% dose decrease (mean dose-length product of 439 mGy × cm vs 1,144 mGy × cm and mean effective dose of 7.5 mSv vs 19.4 mSv, respectively, p <0.0001). Similarly, a 71.5% dose reduction occurred among the 30 patients scanned with the sequential protocol compared to the 40 patients scanned with the helical protocol using either strategy (326 mGy × cm vs 1,141 mGy × cm and 5.5 mSv vs 19.4 mSv, respectively, p <0.0001). Although the image quality did not differ between the strategies, a nonstatistically significant trend was seen toward better quality in the sequential protocol than in the helical protocol. In conclusion, approaching TRO CTA with a diagnostic strategy of sequential scanning, as appropriate, can offer a marked reduction in the radiation dose while maintaining the image quality.
      (Copyright © 2011 Elsevier Inc. All rights reserved.)
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    • Grant Information:
      KL2 RR024157 United States RR NCRR NIH HHS; KL2 RR024157-01 United States RR NCRR NIH HHS; KL2 RR024157 K12 United States RR NCRR NIH HHS
    • Accession Number:
      0 (Adrenergic beta-Antagonists)
    • Publication Date:
      Date Created: 20110211 Date Completed: 20110523 Latest Revision: 20211020
    • Publication Date:
      20221213
    • Accession Number:
      PMC3062669
    • Accession Number:
      10.1016/j.amjcard.2010.11.038
    • Accession Number:
      21306693