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. 2013 Apr 20:6:158.
doi: 10.1186/1756-0500-6-158.

Feasibility of aortic valve assessment with low dose prospectively triggered adaptive systolic (PTAS) cardiac computed tomography angiography

Ashley M Lee, Jonathan Beaudoin, Wai-Ee Thai, Bryan Wai, Gladwin C Hui, Manavjot S Sidhu, Leif-Christopher Engel, Suhny Abbara, Udo Hoffmann, Brian B Ghoshhajra

Feasibility of aortic valve assessment with low dose prospectively triggered adaptive systolic (PTAS) cardiac computed tomography angiography

Ashley M Lee et al. BMC Res Notes. .

Abstract

Background: Cardiac computed tomography angiography (CTA) is feasible for aortic valve evaluation, but retrospective gated protocols required high radiation doses for aortic valve assessment. A prospectively triggered adaptive systolic (PTAS) cardiac CT protocol was recently described in arrhythmia using second-generation dual-source CT. In this study, we sought to evaluate the feasibility of PTAS CTA to assess the aortic valve at a low radiation dose.

Findings: A retrospective cohort of 29 consecutive patients whom underwent PTAS protocols for clinical indications other than aortic valve assessment and whom also received echocardiography within 2 months of CT, was identified. Images were reviewed for aortic valve morphology (tricuspid/bicuspid/prosthetic) and stenosis (AS) by experienced blinded readers. Accuracy versus echocardiography and radiation doses were assessed.

Conclusions: PTAS CTA protocols using second-generation dual-source CT for aortic valve evaluation are feasible at low doses. This protocol should be investigated further in larger cohorts.

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Figures

Figure 1
Figure 1
ECG strip demonstrating timing of image acquisition. PTAS CTA is shown with radiation exposure peak at 100% of the reference tube current (red arrow, “Range” settings) at 300–400 msec and a “plateau” (green arrow, “Scan” settings) with 20% of the reference tube current to capture additional phases at mid and late systole/early diastole.
Figure 2
Figure 2
Bicuspid aortic valve. The cine clip (Additional file 1) shows the open valve (A, C) at 250 mm and closed valve (B, D) at 400 msec. Curved MPR of the normal LAD without stenosis (E).
Figure 3
Figure 3
Example of PTAS CTA in aortic valve evaluation. A: Reconstructions at 250 msec (top row) and 400 msec (bottom row) show the aortic valve in open and closed positions. There is mild restriction of the non-coronary cusp opening (arrows). B: Planimetry shows mild aortic stenosis. No motion artifacts were seen in the coronary arteries (not shown).
See this image and copyright information in PMC

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