Image quality and radiation dose comparison of prospectively triggered low-dose CCTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition

• Published in: The International Journal of Cardiovascular Imaging 2012-06, Vol.28 (5), p.1217-1225
• Main Authors: Ghadri, Jelena R., Küest, Silke M., Goetti, Robert, Fiechter, Michael, Pazhenkottil, Aju P., Nkoulou, Rene N., Kuhn, Felix P., Pietsch, Carsten, von Schulthess, Patrick, Gaemperli, Oliver, Templin, Christian, Kaufmann, Philipp A.
• Format: Article
• Language: English
• Subjects: Aged; Cardiac Imaging; Cardiac-Gated Imaging Techniques; Cardiology; Chi-Square Distribution; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; Electrocardiography; Female; Heart Rate; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography; Observer Variation; Original Paper; Predictive Value of Tests; Prospective Studies; Radiation Dosage; Radiographic Image Interpretation, Computer-Assisted; Radiology; Registries; Reproducibility of Results; Switzerland; Tomography, Spiral Computed
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-011-9921-3

Currently 64-multislice computed tomography (MSCT) scanners are the most widely used devices allowing low radiation dose coronary CT angiography (CCTA) with prospective ECG triggering. Latest 128-slice dual-source CT (DSCT) scanners offer prospective high-pitch spiral acquisition covering the heart during one single beat. We compared radiation dose and image quality from prospective 64-MSCT versus high-pitch spiral 128-slice DSCT scanning, as such data is lacking. CCTA of 50 consecutive patients undergoing 128-DSCT (2 × 64 × 0.6 mm collimation, 0.28 s rotation time, 3.4 pitch, 100–120 kV tube voltage and 320 mAs tube current–time product) were compared to CCTA of 50 heart rate (HR) and BMI matched patients undergoing 64-MSCT (64 × 0.625 mm collimation, 0.35 s rotation time, 100–120 kV tube voltage and 400–650 mA tube current). Image quality was rated on a 4-point scale by two independent cardiac imaging physicians (1 = excellent to 4 = non-diagnostic). Of 710 coronary segments assessed on 128-DSCT, 216 (30.4%) achieved an image quality score 1 excellent, 400 (56.3%) score 2, 76 (10.7%) score 3 and 18 (2.6%) score 4 (non-diagnostic). Of 737 coronary segments evaluated on 64-MSCT 271 (36.8%) had an image quality score of 1, 327 (44.4%) 2, 110 (14.9%) score 3, and 29 (3.9%) segments score 4. Average image quality score for both scanners was similar ( P  = 0.641). The mean heart rate during scanning was 58.7 ± 5.6 bpm on 128-DSCT and 59.0 ± 5.6 bpm on 64-MSCT, respectively. Mean effective radiation dose was 1.0 ± 0.2 mSv for 128-DSCT and 1.7 ± 0.6 mSv for 64-MSCT ( P