Abstract
Background: Electrocardiographic (ECG)-based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective: We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods: We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results: Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen's κ value 0.83; 95% confidence interval, 0.76-0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE (P < 0.0001). Conclusion: Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 149-157 |
| Number of pages | 9 |
| Journal | Journal of Cardiovascular Computed Tomography |
| Volume | 5 |
| Issue number | 3 |
| DOIs | |
| State | Published - May 2011 |
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Keywords
- Dual-source CT
- ECG-based tube current modulation
- Low radiation
- LV function
- Regional wall motion
- Two-dimensional echocardiography
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT : Comparison to two-dimensional echocardiography. / Nakazato, Ryo; Tamarappoo, Balaji K.; Smith, Thomas W R; Cheng, Victor Y.; Dey, Damini; Shmilovich, Haim; Gutstein, Ariel; Gurudevan, Swaminatha; Hayes, Sean W.; Thomson, Louise E J; Friedman, John D.; Berman, Daniel S.
In: Journal of Cardiovascular Computed Tomography, Vol. 5, No. 3, 05.2011, p. 149-157.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT
T2 - Comparison to two-dimensional echocardiography
AU - Nakazato, Ryo
AU - Tamarappoo, Balaji K.
AU - Smith, Thomas W R
AU - Cheng, Victor Y.
AU - Dey, Damini
AU - Shmilovich, Haim
AU - Gutstein, Ariel
AU - Gurudevan, Swaminatha
AU - Hayes, Sean W.
AU - Thomson, Louise E J
AU - Friedman, John D.
AU - Berman, Daniel S.
PY - 2011/5
Y1 - 2011/5
N2 - Background: Electrocardiographic (ECG)-based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective: We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods: We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results: Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen's κ value 0.83; 95% confidence interval, 0.76-0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE (P < 0.0001). Conclusion: Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.
AB - Background: Electrocardiographic (ECG)-based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective: We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods: We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results: Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen's κ value 0.83; 95% confidence interval, 0.76-0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE (P < 0.0001). Conclusion: Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.
KW - Dual-source CT
KW - ECG-based tube current modulation
KW - Low radiation
KW - LV function
KW - Regional wall motion
KW - Two-dimensional echocardiography
UR - http://www.scopus.com/inward/record.url?scp=79958265042&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79958265042&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2011.01.011
DO - 10.1016/j.jcct.2011.01.011
M3 - Article
C2 - 21367686
AN - SCOPUS:79958265042
VL - 5
SP - 149
EP - 157
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
SN - 1934-5925
IS - 3
ER -