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. 2022 Oct 31;12(11):2647.
doi: 10.3390/diagnostics12112647.

Dedicated CCTA Followed by High-Pitch Scanning versus TRO-CT for Contrast Media and Radiation Dose Reduction: A Retrospective Study

Kun Wang  1 , Xiaodong Wang  2 , Shaoqiang Zheng  3 , Cheng Li  1 , Liang Jin  1 , Ming Li  1   4
Affiliations

Dedicated CCTA Followed by High-Pitch Scanning versus TRO-CT for Contrast Media and Radiation Dose Reduction: A Retrospective Study

Kun Wang et al. Diagnostics (Basel). .

Abstract

We aimed to compare dedicated coronary computed tomography angiography (CCTA) followed by high-pitch scanning and triple-rule-out computed tomography angiography (TRO-CTA) in terms of radiation dose, contrast media (CM) use, and image quality. Patients with acute chest pain were retrospectively enrolled and assigned to group A (n = 55; scanned with dedicated CCTA followed by high-pitch scanning) or group B (n = 45; with TRO-CTA). Patient characteristics, radiation dose, CM use, and quantitative parameters (CT value, image noise, signal-to-noise ratio, contrast-to-noise ratio, and image quality score) of pulmonary arteries (PAs), thoracic aortae (TAs), and coronary arteries (CAs) were compared. The total effective dose was significantly lower in group A (6.25 ± 2.94 mSv) than B (8.93 ± 4.08 mSv; p < 0.001). CM volume was significantly lower in group A (75.7 ± 8.9 mL) than B (95.0 ± 0 mL; p < 0.001). PA and TA image quality were significantly better in group B, whereas that of CA was significantly better in group A. Qualitative image scores of PA and TA scans rated by radiologists were similar, whereas that of CA scans was significantly higher in group A than B (p < 0.001). Dedicated CCTA followed by high-pitch scanning demonstrated lower radiation doses and CM volume without debasing qualities of PA, TA, and CA scans than did TRO-CTA.

Keywords: contrast media; coronary CT angiography; high-pitch scanning; image quality; radiation dose.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient enrolment.
Figure 2
Figure 2
(a–c) A 91-year-old man with chief complaint of chest pain (heart rate: 67 bpm). Images were acquired with the optimized scanning scheme. Curved multiplanar reformat computed tomography (CT) images show the right coronary artery (a), left anterior descending artery (b), and left circumflex artery (c). (d–f) A 63-year-old woman presented to the emergency room with several days of chest pain, heart rate 58 bpm. Images were acquired with the traditional triple-rule-out computed tomography angiography (TRO-CTA). Curved multiplanar reformat CT images of the right coronary (d), left anterior descending artery (e), and left circumflex artery (f).
Figure 3
Figure 3
(a–c) A 75-year-old woman with chest pain, heart rate 77 bpm. Images were acquired with the optimized scanning scheme. (d–f) A 67-year-old woman presents to the emergency room with several days of chest pain, heart rate 66 bpm. Images were acquired with the traditional triple-rule-out computed tomography angiography (TRO-CTA). (a,d) are axial maximum intensity projection (MIP) images showing the pulmonary artery; (b,e) are coronal MIP images showing the pulmonary artery; and (c,f) are sagittal MIP images showing the thoracic aorta.
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