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Zhang, Long Jiang; Wang, Yining; Schoepf, U. Joseph; Meinel, Felix G.; Bayer, Richard R.; Qi, Li; Cao, Jian; Zhou, Chang Sheng; Zhao, Yan E.; Li, Xie; Bin Gong, Jian; Jin, Zhengyu; Lu, Guang Ming (2016): Image quality, radiation dose, and diagnostic accuracy of prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp in a clinical setting: comparison with invasive coronary angiography. In: European Radiology, Vol. 26, No. 3: pp. 797-806
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Abstract

To investigate image quality, radiation dose, and diagnostic performance of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp compared to invasive coronary angiography (ICA) as reference standard. Forty-three patients underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp using 30 cc (11 g iodine) contrast medium and ICA. Subjective and objective image quality was evaluated for each CCTA study. CCTA performance for diagnosing a parts per thousand yen50 % stenosis was assessed. Results were stratified according to heart rate (HR), body mass index (BMI), Agatston score, and image quality. At CCTA, 94.3 % (500/530) of coronary segments were of diagnostic quality. Using ICA as reference standard, sensitivity and accuracy were 100 % and 93.0 % on a per-patient basis. Per-vessel and per-segment performances were 92.2 % and 89.5 %;79.5 % and 88.3 %, respectively. No differences were found in diagnostic accuracy between different HR, BMI, and calcification subgroups (all P > 0.05) on a per-patient basis. However, low image quality reduced diagnostic accuracy on a per-patient, per-vessel and per-segment basis (all P < 0.05). The mean effective radiation dose was 0.2 +/- 0.0 mSv. Our presented protocol results in an effective radiation dose of 0.2 mSv and high diagnostic accuracy for stenosis detection in a selected, non-obese population. aEuro cent Prospectively ECG-triggered high-pitch CCTA at 70 kVp is feasible. aEuro cent This protocol has a high diagnostic accuracy for stenosis detection. aEuro cent The mean effective radiation dose was 0.2 +/- 0.0 mSv. aEuro cent Only 30 cc of contrast material is used in this protocol. aEuro cent Low image quality reduced diagnostic accuracy of CCTA.