Evidence map›Paper›PMID 28702479›Full record

ArticleEuropean journal of radiology open2017

Image quality and contrast agent exposure in cardiac computed tomography angiography prior to transcatheter aortic valve implantation procedures using different acquisition protocols.

Nina P Hofmann, Moritz Schuetz, Raffi Bekeredjian, Sven Pleger, Emanuel Chorianopoulos, Sorin Giusca, Florian André, Gitsios Gitsioudis, Christopher Schlett, Hans-Ulrich Kauczor and 2 more

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Article in European journal of radiology open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Nina P HofmannDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Moritz SchuetzDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Raffi BekeredjianDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Sven PlegerDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Emanuel ChorianopoulosDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Sorin GiuscaDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Florian AndréDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Gitsios GitsioudisDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Christopher SchlettDepartment of Radiology, University of Heidelberg, Heidelberg, Germany.
Hans-Ulrich KauczorDepartment of Radiology, University of Heidelberg, Heidelberg, Germany.
Hugo A KatusDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.
Grigorios KorosoglouDepartment of Cardiology, University of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundECG-gated cardiac computed tomography angiography (CCTA) has found widespread use for prosthesis sizing before transcatheter aortic valve implantation (TAVI). However, still little data exists on the optimal scan-strategy in such patients. We hypothesized that prospectively triggered CCTA can enable the visualization of aortic valve structures and peripheral arteries with lower radiation and contrast agent exposure in patients considered for TAVI compared to retrospectively gated protocols.

methodsAll studies were performed using a 256 multi-detector single source CT (iCT Philips, Best, Netherlands). With the prospective protocol the whole volume from the heart to the iliofemoral arteries scanned using prospective triggering. With the retrospective protocol a first retrospectively gated scan was performed for the heart and the iliofemoral part was subsequently scanned using a second non-triggered scan. Image quality was assessed semi-quantitatively and signal-to-noise- (SNR) and contrast-to-noise-ratios (CNR) were obtained for all scans.

resultsProspective CCTA was performed in 74 and in 34 patients, respectively using non-tailored and BMI adapted scans, whereas retrospective CCTA was performed in 57 patients. Prospective scans required lower contrast agent administration compared to retrospective scans (71 ± 8 mL versus 91 ± 15 mL, p < 0.01) and resulted in lower radiation exposure (26 ± 7mSv for retrospective versus 15 ± 3mSv for non-tailored prospective versus 8 ± 4mSv for BMI-adapted prospective scans, p < 0.01). Visual image quality was better for the evaluation of aortic valve structures and similar for the assessment of iliofemoral anatomy with prospective versus retrospective scans. In addition, contrast density, SNR and CNR were higher in the ascending aorta with prospective versus retrospective CCTA (434 ± 98HU versus 349 ± 112HU; 35 ± 14 versus 24 ± 9 and 31 ± 11 versus 16 ± 7, p < 0.001 for all). Subsection analysis by heart rate groups demonstrated that both image quality and CNR were significantly higher in patients with prospective versus retrospective CCTA, irrespective of the heart rate during image acquisition.

conclusionProspectively triggered CCTA allows for improved visualization of aortic valve structures and peripheral arteries in patients scheduled for TAVI with simultaneously reduced contrast agent dose and radiation exposure. Therefore, this acquisition mode seems to be the preferred for the evaluation of patients considered for TAVI.

Indexed as

Cardiac computed tomography TAVICNRImage qualityRadiation exposureSNR

Identifiers

PMID28702479
PMCPMC5491755

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