Feasibility of prospectively ECG-triggered high-pitch coronary CT angiography with 30 mL iodinated contrast agent at 70 kVp: initial experience

Eur Radiol. 2014 Jul;24(7):1537-46. doi: 10.1007/s00330-014-3157-2. Epub 2014 Apr 16.

Abstract

Objectives: To evaluate the feasibility, image quality and radiation dose of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) with 30 mL contrast agent at 70 kVp.

Methods: Fifty-eight patients with suspected coronary artery disease, a body mass index (BMI) of less than 25 kg/m(2), sinus rhythm and a heart rate (HR) of less than 70 beats per minute (bpm) were prospectively enrolled in this study. Thirty mL of 370 mg I/mL iodinated contrast agent was administrated at a flow rate of 5 mL/s. All patients underwent prospectively ECG-triggered high-pitch CCTA on a second-generation dual-source CT system at 70 kVp using automated tube current modulation.

Results: Fifty-six patients (96.6%) had diagnostic CCTA images and two patients (3.4%) had one vessel with poor image quality each rated as non-diagnostic. No significant effects of HR, HR variability and BMI on CCTA image quality were observed (all P > 0.05). Effective dose was 0.17 ± 0.02 mSv and the size-specific dose estimate was 1.03 ± 0.13 mGy.

Conclusion: Prospectively ECG-triggered high-pitch CCTA at 70 kVp with 30 mL of contrast agent can provide diagnostic image quality at a radiation dose of less than 0.2 mSv in patients with a BMI of less than 25 kg/m(2) and an HR of less than 70 bpm.

Key points: • Prospectively ECG-triggered high-pitch CCTA at 70 kVp/30 mL contrast agent is feasible. • Diagnostic image quality can be obtained at a radiation dose of less than 0.2 mSv. • This protocol is suitable for normal-weight patients with slow heart rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media / administration & dosage
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / physiopathology
  • Electrocardiography*
  • Feasibility Studies
  • Female
  • Humans
  • Injections, Intravenous
  • Iohexol / administration & dosage
  • Iohexol / analogs & derivatives*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Prospective Studies
  • Radiation Dosage
  • Radiographic Image Interpretation, Computer-Assisted*
  • Reproducibility of Results

Substances

  • Contrast Media
  • Iohexol
  • iopromide