Coronary CT angiography in patients with atrial fibrillation: Standard-dose and low-dose imaging with a high-resolution whole-heart CT scanner

Matveeva A, Schmitt RR, Edtinger K, Wagner M, Kerber S, Deneke T, Uder M, Barth S (2018)


Publication Type: Journal article

Publication year: 2018

Journal

Book Volume: 28

Pages Range: 3432-3440

Journal Issue: 8

DOI: 10.1007/s00330-017-5282-1

Abstract

OBJECTIVE: To compare image quality, observer confidence, radiation exposure in the standard-dose (SD-CCTA) and low-dose (LD-CCTA) protocols of coronary CT angiography (CCTA) in patients with atrial fibrillation (AF). MATERIAL AND METHODS: CCTA was performed in 303 patients using a CT scanner with 16-cm coverage (111 scans during sinus rhythm (SR); 192 during AF). LD-CCTA was used in 218 patients; SD-CCTA in 85 patients suspected of having coronary artery disease (CAD). Image quality and observer confidence were evaluated on 5-point scales. Radiation doses were recorded. RESULTS: Image quality was superior in the SD-CCTA compared to the LD-CCTA (SR 1.45±0.40; AF 1.72±0.46; vs. SR 1.83±0.48; AF 1.92±0.50; p < 0.001). Observers were more confident with SD-CCTA than with LD-CCTA (SR 1.38±0.33; AF 1.61±0.43; vs. SR 1.70±0.45; AF 1.82±0.50; p < 0.001). Radiation doses in AF were significantly higher than in the SR (LD-CCTA, 1.68±0.71 mSv; SD-CCTA, 3.72±1.95 mSv; vs. LD-CCTA, 1.3 ±0.52 mSv; SD-CCTA, 2.67±1.47 mSv; p < 0.001). CONCLUSION: Using a low-dose protocol in AF, radiation exposure can be decreased by 50 % at the expense of 20 % impaired image quality. A low-dose CCTA protocol can be considered in young patients, whereas the standard-dose protocol is recommended for older patients and those suspected of having CAD. KEY POINTS: • Whole-heart CT allows visualization of the coronary arteries in atrial fibrillation. • Low-dose CT decreases radiation exposure by 50%, image quality by 20%. • Standard-dose CT seems advantageous when concomitant coronary artery disease is suspected.

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How to cite

APA:

Matveeva, A., Schmitt, R.R., Edtinger, K., Wagner, M., Kerber, S., Deneke, T.,... Barth, S. (2018). Coronary CT angiography in patients with atrial fibrillation: Standard-dose and low-dose imaging with a high-resolution whole-heart CT scanner. European Radiology, 28(8), 3432-3440. https://dx.doi.org/10.1007/s00330-017-5282-1

MLA:

Matveeva, Anna, et al. "Coronary CT angiography in patients with atrial fibrillation: Standard-dose and low-dose imaging with a high-resolution whole-heart CT scanner." European Radiology 28.8 (2018): 3432-3440.

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