Low-dose Coronary-CT Angiography Using Step and Shoot at Any Heart Rate: Comparison of Image Quality at Systole for High Heart Rate and Diastole for Low Heart Rate with a 128-slice Dual-source Machine
Overview
Affiliations
To compare image quality of coronary CT angiography in step-and-shoot mode at the diastolic phase at low heart rates (<70 bpm) and systolic phase at high heart rates (≥70 bpm). We prospectively included 96 consecutive patients then excluded 5 patients with arrhythmia. Coronary CT-angiography was performed using a dual-source 128-slice CT machine, at the diastolic phase in the 55 patients with heart rates <70 bpm (group D) and at the systolic phase in the 36 patients with heart rates ≥70 (group S). Image quality was scored on a 5 point-scale (1, not interpretable; 2, insufficient for diagnosis; 3, fair, sufficient for diagnosis; 4, good; 5, excellent). In addition, we compared the number of stair-step artifacts in the two groups. Mean image quality score was 4 (0.78) in group D and 4.1 (0.34) in group S (NS), with an unequal distribution (p = 0.01). Step artifacts were seen in 44 % of group D and 18 % of group S patients (p = 0.02). In 3 group D patients and no group S patients, the image score was <3 due to artifacts, requiring repeat CT-angiography. When performing dual-source 128-slice CT-angiography, step-and-shoot acquisition provides comparable mean image quality in systole, with less variability and fewer stair-step artifacts, compared to diastole. This method may be feasible at any heart rate in most patients in sinus rhythm, allowing low-dose prospective acquisition without beta-blocker premedication.
Lisi C, Moser L, Mergen V, Flohr T, Eberhard M, Alkadhi H Eur J Radiol Open. 2024; 12:100574.
PMID: 38882632 PMC: 11179571. DOI: 10.1016/j.ejro.2024.100574.
Moser L, Mergen V, Allmendinger T, Manka R, Eberhard M, Alkadhi H Invest Radiol. 2024; 59(9):622-628.
PMID: 38284879 PMC: 11827681. DOI: 10.1097/RLI.0000000000001066.
Jin L, Jie B, Gao Y, Jiang A, Weng T, Li M Quant Imaging Med Surg. 2021; 11(6):2598-2609.
PMID: 34079726 PMC: 8107323. DOI: 10.21037/qims-20-500.
Yang C, Law W, Lu K, Wu T Br J Radiol. 2019; 92(1101):20180945.
PMID: 31322906 PMC: 6732907. DOI: 10.1259/bjr.20180945.
Takase M, Fujimoto S, Takamura K, Yamashita H, Uno K, Aoki S Radiol Phys Technol. 2016; 9(2):214-20.
PMID: 26984733 DOI: 10.1007/s12194-016-0351-8.