Triple-rule-out CT angiography using two axial scans with 16 cm wide-detector for radiation dose reduction
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To explore the use of two consecutive axial scans in triple-rule-out (TRO) examination on a 16 cm wide-detector CT for radiation dose reduction.
Materials and methods
Sixty TRO patients were assigned to either study group (Group A, n = 30) or control group (Group B, n = 30). Group A used a two-phasic contrast injection: 25mgI/kg/s for 12 s in 1st and at 3.0 ml/s injection rate for 7 s in 2nd phase. The pulmonary artery, coronary artery and aorta were scanned in succession with two axial scans using smart-coverage technique. Group B used the conventional protocol of scanning pulmonary arteries first in helical, followed by coronary arteries in axial and aorta in helical mode with contrast injection of 25mgI/kg/s for 14 s. All images were reconstructed with 80% ASIR-V. The qualitative and quantitative image assessment and effective dose of the two groups were statistically compared.
The demographic data and quantitative measurements and qualitative image scores between the two groups were statistically the same (p > 0.05). However, Group A reduced radiation dose by 52% (2.67 ± 0.98 mSv vs. 5.65 ± 1.37 mSv) (p < 0.001).
Using two consecutive axial scans in triple-rule-out on a 16 cm wide-detector CT reduces radiation dose while maintaining image quality compared with the conventional TRO protocol.
• Triple-rule-out can be performed with two-axial scans on a wide-detector CT system.
• TRO with two-axial scans maintain image quality compared with conventional protocol.
• TRO with two-axial scans reduces 52% radiation dose over conventional protocol.
KeywordsChest pain Radiation dosage Diagnostic imaging Computed tomography angiography Tomography, X-ray computed
Acute coronary syndrome
Adaptive statistical iterative reconstruction
Computed tomography angiography
CT dose index
Display field of view
Maximum intensity projection
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Taiping He.
Conflict of interest
The authors of this manuscript declare no conflict of interest exits in the submission of this manuscript.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• randomized controlled trial
• performed at one institution
- 2.Kim HS, Kim SM, Cha MJ et al (2017) Triple rule-out CT angiography protocol with restricting field of view for detection of pulmonary thromboembolism and aortic dissection in emergency department patients: simulation of modified CT protocol for reducing radiation dose. Acta Radiol 58(5):521–527CrossRefGoogle Scholar
- 7.Andreini D, Pontone G, Mushtaq S et al (2017) Image quality and radiation dose of coronary CT angiography performed with whole-heart coverage CT scanner with intra-cycle motion correction algorithm in patients with atrial fibrillation. Eur Radiol. https://doi.org/10.1007/s00330-017-5131-2 CrossRefGoogle Scholar
- 8.Wong DTL, Soh SY, Ko BS et al (2014) Superior CT coronary angiography image quality at lower radiation exposure with second generation 320-detector row CT in patients with elevated heart rate: a comparison with first generation 320-detector row CT. Cardiovasc Diagn Ther 4(4):299–306PubMedPubMedCentralGoogle Scholar
- 10.European guideline on quality criteria for computed tomography (1999) Brussels, Belgium Report EUR 16262 ENGoogle Scholar