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Prevention of Coronary Artery Disease-Related Heart Failure: The Role of Computed Tomography Scan. Heart Fail Clin 2021; 17:187-194. [PMID: 33673944 DOI: 10.1016/j.hfc.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
During the past decade, coronary computed tomography angiography has emerged as the primary modality to noninvasively detect and rule out coronary artery disease. Therefore, this technique could play an important role in identifying patients at high risk of heart failure, considering the high prevalence of coronary artery disease in these patients. The latest technologies have also increased diagnostic accuracy, helping to close the gap with the other functional imaging modalities.
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Madaj P, Li D, Nakanishi R, Andreini D, Pontone G, Conte E, O’Rourke Franzcr R, Hamilton-Craig C, Nimmagadda M, Kim N, Fatima B, Dailing C, Budoff MJ. Lower Radiation Dosing in Cardiac CT Angiography: The CONVERGE Registry. J Nucl Med Technol 2020; 48:58-62. [DOI: 10.2967/jnmt.119.229500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022] Open
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The effect of heart rate, vessel angulation and acquisition protocol on the estimation accuracy of calcified artery stenosis in dual energy cardiac CT: A phantom study. Phys Med 2020; 70:208-215. [DOI: 10.1016/j.ejmp.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/28/2020] [Accepted: 02/05/2020] [Indexed: 01/17/2023] Open
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Meng D, Cui X, Bai C, Yu Z, Xin L, Fu Y, Wang S, Du Y, Gao Z, Ye Z. Application of low-concentration contrast agents and low-tube-voltage computed tomography to chest enhancement examinations: A multicenter prospective study. Sci Prog 2020; 103:36850419892193. [PMID: 31791209 PMCID: PMC10358470 DOI: 10.1177/0036850419892193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To evaluate the influence of low-concentration contrast agents and low-tube-voltage computed tomography on chest enhancement examinations, we conducted a multicenter prospective study. A total of 216 inpatients enrolled from 12 different hospitals were randomly divided into four groups: A: voltage, 120 kVp; iohexol, 350 mgI/mL; B: voltage, 100 kVp, iohexol, 350 mgI/mL; C: voltage, 120 kVp, iodixanol, 270 mgI/mL; and D: voltage, 100 kVp, iodixanol, 270 mgI/mL. Subjective image quality was assessed by two radiologists and compared by weighted kappa test. The objective image scores, scanning radiation doses, and pathological coincidence rates were analyzed. There were no significant differences in gender, age, height, weight, and body mass index between the four groups (p > 0.05). The consistency of the radiologists' ratings were good, with kappa value ranging from 0.736 (95% confidence interval: 0.54-0.933) to 0.809 (95% confidence interval: 0.65-0.968), and there was no difference in subjective image score between the four groups. The computed tomography value of group D had no difference with group A. The volume computed tomography dose index, dose length product, and effective dose of group D (6.93 ± 3.03, 241.55 ± 104.75, and 3.38 ± 1.47, respectively) were all significantly lower than those of group A (10.30 ± 4.37, 359.70 ± 152.65, and 5.04 ± 2.14, respectively). There was no significant difference in the imaging diagnosis accuracy rate between the four groups (p > 0.05). The results indicated that low-concentration contrast agents (270 mgI/mL) and low-tube-voltage (100 kVp) computed tomography can not only decrease radiation dose but also guarantee the image quality and meet the needs of imaging diagnosis in chest enhancement examinations, which make it possible for its generalization and application.
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Affiliation(s)
- Donghua Meng
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Xiaonan Cui
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Changsen Bai
- Department of Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Zhongwen Yu
- Department of Radiology, China Resources Wuhan Iron and Steel General Hospital, Wuhan, China
| | - Lei Xin
- Department of Radiology, Shanxi Cancer Hospital, Taiyuan, China
| | - Yufei Fu
- Department of Radiology, Edong Medical Group Central Hospital, Huangshi, China
| | | | - Yu Du
- Department of Radiology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhipeng Gao
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China
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A comparison study of radiation effective dose in ECG-Gated Coronary CT Angiography and calcium scoring examinations performed with a dual-source CT scanner. Sci Rep 2019; 9:4374. [PMID: 30867480 PMCID: PMC6416329 DOI: 10.1038/s41598-019-40758-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 02/21/2019] [Indexed: 11/08/2022] Open
Abstract
In this report we have evaluated radiation effective dose received by patients during ECG-gated CCTA examinations based on gender, heart rate, tube voltage protocol and body mass index (BMI). A total of 1,824 patients were retrospectively recruited (1,139 men and 685 women) and they were divided into Group 1 (CCTA with calcium scoring), Group 2 (CCTA without calcium scoring) and Group 3 (only calcium scoring), where the association between gender, heart rate, tube voltage protocol and body mass index (BMI) were analysed. Examinations were performed using a retrospective ECG-gated CCTA protocol and the effective doses were calculated from the dose length product with a conversion coefficient of 0.026 mSv.mGy-1cm-1. No significant differences were observed in the mean effective dose between gender in all groups. The mean estimated dose was significantly higher when the heart rate was lower in Group 1 (p < 0.001) and Group 2 (p = 0.002). There were also significant differences between the mean effective dose in tube voltage protocol and BMI among the three groups. The mean effective dose was positively correlated with BMI (p < 0.001), but inversely related to the heart rate. This study supported the theory that a high heart rate, low tube voltage and low BMI could significantly reduce radiation dose exposure.
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Tatsugami F, Higaki T, Sakane H, Nakamura Y, Iida M, Baba Y, Fujioka C, Senoo A, Kitagawa T, Yamamoto H, Kihara Y, Awai K. Diagnostic accuracy of in-stent restenosis using model-based iterative reconstruction at coronary CT angiography: initial experience. Br J Radiol 2017; 91:20170598. [PMID: 29022741 DOI: 10.1259/bjr.20170598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The purpose of our study was to compare the diagnostic performance of coronary CT angiography (CTA) subjected to model-based iterative reconstruction (IR) or hybrid IR to rule out coronary in-stent restenosis. METHODS We enrolled 16 patients who harboured 22 coronary stents. They underwent coronary CTA on a 320-slice CT scanner. The images were reconstructed with hybrid IR (AIDR 3D) and model-based IR (FIRST) algorithms. We calculated the stent lumen attenuation increase ratio and measured the visible stent lumen diameter. Two blinded observers visually graded the likelihood of in-stent restenosis (lesions ≥ 50%) on hybrid IR and FIRST images. RESULTS The stent lumen attenuation increase ratio on FIRST- was lower than on AIDR 3D images (0.20 vs 0.32). The ratio of the visible- compared to the true stent lumen diameter was higher on FIRST- than AIDR 3D images (52.5 vs 47.5%). Invasive coronary angiography identified five stents (22.7%) with significant in-stent restenosis. The use of FIRST improved the sensitivity (60 vs 100%), positive (75.0 vs 83.3%) and negative predictive value (88.9 vs 100%) and the accuracy (86.4 vs 95.5%) for the detection of in-stent restenosis. Specificity was 94.1% for both reconstruction methods. CONCLUSION The model-based IR algorithm may improve diagnostic performance for the detection of in-stent restenosis. Advances in knowledge: Compared to hybrid IR, the new model-based IR algorithm reduced blooming artefacts and improved the image quality. It can be expected to improve diagnostic performance for the detection of in-stent restenosis on coronary CTA images.
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Affiliation(s)
- Fuminari Tatsugami
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Toru Higaki
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Hiroaki Sakane
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Yuko Nakamura
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Makoto Iida
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Yasutaka Baba
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
| | - Chikako Fujioka
- 2 Department of Radiology, Hiroshima University , Hiroshima, Japan
| | - Atsuhiro Senoo
- 3 Department of Cardiovascular Medicine, Hiroshima University , Hiroshima, Japan
| | - Toshiro Kitagawa
- 3 Department of Cardiovascular Medicine, Hiroshima University , Hiroshima, Japan
| | - Hideya Yamamoto
- 3 Department of Cardiovascular Medicine, Hiroshima University , Hiroshima, Japan
| | - Yasuki Kihara
- 3 Department of Cardiovascular Medicine, Hiroshima University , Hiroshima, Japan
| | - Kazuo Awai
- 1 Department of Diagnostic Radiology, Hiroshima University , Hiroshima, Japan
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