Non-ECG-gated high-pitch CT angiography versus hybrid ECG-gated CT angiography for aorta using 512-slice CT: comparison of image quality and radiation dose

Abstract

Background

There have been few reports comparing image quality and radiation dose of aorta computed tomography angiography (CTA) between the high-pitch and the hybrid technique.

Purpose

To compare the image quality and radiation dose among non-electrocardiogram (ECG)-gated high-pitch CTA and hybrid ECG-gated CTA of the aorta using 512-slice CT.

Material and Methods

This retrospective study included 110 patients who underwent non-ECG-gated high-pitch CTA (group 1) or hybrid ECG-gated CTA (group 2) of the entire aorta. Interpretability, image noise, contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and the mean effective radiation dose were compared.

Results

The mean image noise of the whole aorta was significantly lower (15.7 ± 1.8 HU vs. 16.5 ± 1.2 HU, P = 0.008) in group 1 than in group 2. The CNR (22.3 ± 4.7 vs. 20.0 ± 3.9, P < 0.001) and SNR (26.5 ± 4.9 vs. 23.2 ± 4.0, P < 0.001) were higher in group 2 compared with group 1. Neither group showed a significant difference in interpretability of the ascending aorta, cardiac chamber, aortic valve, right ostium, and left ostium (all P = 1). The mean effective radiation dose was significantly lower in group 1 than in group 2 (3.5 ± 0.9 mSv vs. 4.3 ± 0.8 mSv, P < 0.001).

Conclusion

The non-ECG-gated high-pitch technique shows significantly improved CNR and SNR due to reduced noise with lower radiation exposure. The interpretability of the cardiac structure, ascending aorta, aortic valve, and both ostia did not differ significantly between the two groups.

Keywords

Tomography X-ray computed aorta radiation dosage ECG-triggered imaging technique

Get full access to this article

View all access options for this article.

References

Liu

, et al. The ascending aortic image quality and the whole aortic radiation dose of high-pitch dual-source CT angiography. J Cardiothorac Surg 2013;8:28.

Roos

Willmann

Weishaupt

, et al. Thoracic aorta: motion artifact reduction with retrospective and prospective electrocardiography-assisted multi-detector row CT. Radiology 2002;222:271–277.

Smith

Schoenhagen

. CT Imaging for acute aortic syndrome. Cleve Clin J Med 2008;75:7–9. 12, 15–17 passim.

Nagpal

Agrawal

Saboo

, et al.

Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!

Insights Imaging 2020;11:51.

Beeres

Schell

Mastragelopoulos

, et al. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: initial experience. Eur Radiol 2012;22:129–137.

Apfaltrer

Hanna

Schoepf

, et al. Radiation dose and image quality at high-pitch CT angiography of the aorta: intraindividual and interindividual comparisons with conventional CT angiography. AJR Am J Roentgenol 2012;199:1402–1409.

Goetti

Baumuller

Feuchtner

, et al.

High-pitch dual-source CT angiography of the thoracic and abdominal aorta: is simultaneous coronary artery assessment possible?

AJR Am J Roentgenol 2010;194:938–944.

Lee

Kim

Lee

, et al. Hybrid ECG-gated versus non-gated 512-slice CT angiography of the aorta and coronary artery: image quality and effect of a motion correction algorithm. Acta Radiol 2018;59:170–179.

Wichmann

Hardie

Schoepf

, et al. Single- and dual-energy CT of the abdomen: comparison of radiation dose and image quality of 2nd and 3rd generation dual-source CT. Eur Radiol 2017;27:642–650.

10.

Farshad-Amacker

Alkadhi

Leschka

, et al. Effect of high-pitch dual-source CT to compensate motion artifacts: a phantom study. Acad Radiol 2013;20:1234–1239.

11.

. European Commision. European guidelines on quality criteria for computed tomography. Luxembourg: Publications Office of the European Union, 2000.

12.

Shen

Sun

, et al. High-pitch, low-voltage and low-iodine-concentration CT angiography of aorta: assessment of image quality and radiation dose with iterative reconstruction. PLoS One 2015;10:e0117469.

13.

Landis

Koch

. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174.

14.

Howard

Banerjee

Fairhead

, et al. Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford vascular study. Circulation 2013;127:2031–2037.

15.

Karlo

Leschka

Goetti

, et al. High-pitch dual-source CT angiography of the aortic valve-aortic root complex without ECG-synchronization. Eur Radiol 2011;21:205–212.

16.

Korn

Fenchel

Bender

, et al. High-pitch dual-source CT angiography of supra-aortic arteries: assessment of image quality and radiation dose. Neuroradiology 2013;55:423–430.

17.

Wielandner

Beitzke

Schernthaner

, et al. Is ECG triggering for motion artefact reduction in dual-source CT angiography of the ascending aorta still required with high-pitch scanning? The role of ECG-gating in high-pitch dual-source CT of the ascending aorta. Br J Radiol 2016;89:20160174.

18.

Beeres

Wichmann

Frellesen

, et al. ECG-gated versus non-ECG-gated high-pitch dual-source CT for whole body CT angiography (CTA). Acad Radiol 2016;23:163–167.

19.

Machida

Tanaka

Fukui

, et al. Current and novel imaging techniques in coronary CT. Radiographics 2015;35:991–1010.

20.

Grimmer

Oelhafen

Elstrom

, et al. Cone-beam CT image reconstruction with extended z range. Med Phys 2009;36:3363–3370.

21.

Kang

. Clinical applications of wide-detector CT scanners for cardiothoracic imaging: an update. Korean J Radiol 2019;20:1583–1596.

22.

Zhang

Wang

Schoepf

, et al. 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. Eur Radiol 2016;26:797–806.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB