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. 2023 Oct 12;10(10):424.
doi: 10.3390/jcdd10100424.

Investigating the Influence of High-Speed Gantry Rotation in Cardiac CT on Motion Artifacts in Aortic Stenosis Patients Not Premedicated with β-Blockers: The FAST-CCT Randomized Trial Protocol

Guillaume Fahrni  1 , Giuseppe Gullo  1 , Aisha Touray  1 , Stéphane Fournier  2 , Anne-Marie Jouannic  1 , Henri Lu  2 , Damien Racine  3 , Olivier Muller  2 , Chiara Pozzessere  1 , Salah D Qanadli  4   5 , David C Rotzinger  1
Affiliations

Investigating the Influence of High-Speed Gantry Rotation in Cardiac CT on Motion Artifacts in Aortic Stenosis Patients Not Premedicated with β-Blockers: The FAST-CCT Randomized Trial Protocol

Guillaume Fahrni et al. J Cardiovasc Dev Dis. .

Abstract

Background: Coronary CT angiography (CCTA) is increasingly used as a non-invasive tool to assess coronary artery disease (CAD). However, CCTA is subject to motion artifacts, potentially limiting its clinical utility. Despite faster (0.35 and 0.28 s/rot) gantry rotation times, low (60-65 bpm) heartbeat is recommended, and the use of β-blockers is often needed. Technological advancements have resulted in the development of faster rotation speeds (0.23 s/rot). However, their added value in patients not premedicated with β-blockers remains unclear. This prospective single-center, two-arm, randomized, controlled trial aims to assess the influence of fast rotation on coronary motion artifacts, diagnostic accuracy of CCTA for CAD, and patient safety.

Methods: We will randomize a total of 142 patients aged ≥ 50 scheduled for an aortic stenosis work-up to receive CCTA with either a fast (0.23) or standard (0.28 s/rot) gantry speed.

Primary outcome: rate of CCTAs with coronary motion artifacts hindering interpretation.

Secondary outcomes: assessable coronary segments rate, diagnostic accuracy against invasive coronary angiography (ICA), motion artifact magnitude per segment, contrast-to-noise ratio (CNR), and patient ionizing radiation dose. The local ethics committee has approved the protocol. Potential significance: FAST-CCT may improve motion artifact reduction and diagnosis quality, thus eliminating the need for rate control and β-blocker administration.

Clinicaltrials: gov identifier: NCT05709652.

Keywords: 0.23; CCTA; TAVI; aortic stenosis; beta-blockers; gantry rotation speed; high-speed; motion artifacts; protocol.

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Conflict of interest statement

D.C.R: consultancy for GE Healthcare. O.M.: research grant & honoraria for Edwards and honoraria for Abbott. S.F.: honoraria for Abbott & Edwards. The other authors declare no competing interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Examples of coronary CT angiography images illustrating the range of motion artifact magnitudes. Each panel corresponds to a qualitative rating on a 4-point scale: (a) poor, open-headed arrow indicates severe artifacts impairing accurate evaluation, segment classified as non-evaluable; score = 1, (b) adequate, white arrow indicates moderate artifacts, acceptable for routine clinical diagnosis; score = 2, (c) good, white arrowhead indicates minor artifacts, good diagnostic quality; score = 3, and (d) excellent, no artifacts; score = 4.
See this image and copyright information in PMC

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