Coronary CT angiography with single-source and dual-source CT: Comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols

Akmal Sabarudin, Zhonghua Sun, Ahmad Khairuddin Md Yusof

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). Methods: A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. Results: A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0% classified as of sufficient and 2.0% as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5±2.9 mSv) and SSCT (6.2±1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2±8.3 mSv) than with SSCT (28.3±7.0 mSv) in the retrospective gated protocol. Conclusions: Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality.

Original languageEnglish
Pages (from-to)746-753
Number of pages8
JournalInternational Journal of Cardiology
Volume168
Issue number2
DOIs
Publication statusPublished - 30 Sep 2013

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Coronary Angiography
Electrocardiography
Radiation
Computed Tomography Angiography
Signal-To-Noise Ratio
Noise
Coronary Artery Disease
Coronary Vessels

Keywords

  • Dual-source CT
  • Image quality
  • Prospective ECG triggering
  • Radiation dose
  • Retrospective ECG gating
  • Single-source CT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{203762e131e343eebaa8c64a63327ba5,
title = "Coronary CT angiography with single-source and dual-source CT: Comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols",
abstract = "Background: This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). Methods: A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. Results: A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0{\%} classified as of sufficient and 2.0{\%} as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5±2.9 mSv) and SSCT (6.2±1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2±8.3 mSv) than with SSCT (28.3±7.0 mSv) in the retrospective gated protocol. Conclusions: Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality.",
keywords = "Dual-source CT, Image quality, Prospective ECG triggering, Radiation dose, Retrospective ECG gating, Single-source CT",
author = "Akmal Sabarudin and Zhonghua Sun and Yusof, {Ahmad Khairuddin Md}",
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T1 - Coronary CT angiography with single-source and dual-source CT

T2 - Comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols

AU - Sabarudin, Akmal

AU - Sun, Zhonghua

AU - Yusof, Ahmad Khairuddin Md

PY - 2013/9/30

Y1 - 2013/9/30

N2 - Background: This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). Methods: A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. Results: A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0% classified as of sufficient and 2.0% as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5±2.9 mSv) and SSCT (6.2±1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2±8.3 mSv) than with SSCT (28.3±7.0 mSv) in the retrospective gated protocol. Conclusions: Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality.

AB - Background: This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). Methods: A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. Results: A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0% classified as of sufficient and 2.0% as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5±2.9 mSv) and SSCT (6.2±1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2±8.3 mSv) than with SSCT (28.3±7.0 mSv) in the retrospective gated protocol. Conclusions: Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality.

KW - Dual-source CT

KW - Image quality

KW - Prospective ECG triggering

KW - Radiation dose

KW - Retrospective ECG gating

KW - Single-source CT

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