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Dual-source cardiac computed tomography: image quality and dose considerations

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Abstract

Computed tomography (CT) imaging of the heart, most prominently coronary CT angiography, is currently subject to intense interest and is increasingly incorporated into clinical decision-making. In spite of tremendous progress in CT technology over the past decade, the limited temporal resolution has remained one of the most severe problems, especially for cardiac imaging. The novel design concept of dual-source CT (DSCT) allows for an effective scan time of 83 ms independent of heart rate. While large trials are still missing, initial studies have shown improved image quality, especially for visualizing the coronary arteries and detecting coronary artery stenoses. Further investigations have shown that routine beta blockade to lower the heart rate is not necessary to reliably achieve diagnostic image quality. Other applications that may particularly benefit from increased temporal resolution are the analysis of ventricular function and of the cardiac valves. Dose issues which are of interest for cardiac CT in general are discussed in some detail, including a quantitative analysis of dose values and three-dimensional dose distributions. Various strategies to lower radiation exposure are available today, and DSCT offers specific potential for this.

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References

  1. Kachelriess M, Kalender WA (1998) ECG-correlated image reconstruction from subsecond spiral CT scans of the heart. Med Phys 25:2417–2431

    Article  PubMed  CAS  Google Scholar 

  2. Klingenbeck-Regn K, Schaller S, Flohr T, Ohnesorge B, Kopp AF, Baum U (1999) Subsecond multi-slice computed tomography: basics and applications. Eur J Radiol 31:110–124

    Article  PubMed  CAS  Google Scholar 

  3. Kachelriess M, Ulzheimer S, Kalender WA (2000) ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart. Med Phys 27:1881–1902

    Article  PubMed  CAS  Google Scholar 

  4. Ohnesorge B, Flohr T, Becker C, Kopp AF, Schoepf UJ, Baum U, Knez A, Klingenbeck-Regn K, Reiser MF (2000) Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology 217:564–571

    PubMed  CAS  Google Scholar 

  5. Achenbach S, Ulzheimer S, Baum U, Kachelriess M, Ropers D, Giesler T, Bautz W, Daniel WG, Kalender WA, Moshage W (2000) Noninvasive coronary angiography by retrospectively ECG-gated multislice spiral CT. Circulation 102:2823–2828

    PubMed  CAS  Google Scholar 

  6. Nieman K, Oudkerk M, Rensing BJ, van Ooijen P, Munne A, van Geuns RJ, de Feyter PJ (2001) Coronary angiography with multi-slice computed tomography. Lancet 357:599–603

    Article  PubMed  CAS  Google Scholar 

  7. Achenbach S, Giesler T, Ropers D, Ulzheimer S, Derlien H, Schulte C, Wenkel E, Moshage W, Bautz W, Daniel WG, Kalender WA, Baum U (2001) Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 103:2535–2538

    PubMed  CAS  Google Scholar 

  8. Kalender WA (2005) Computed tomography. Publicis, Erlangen

    Google Scholar 

  9. Achenbach S (2006) Computed tomography coronary angiography. J Am Coll Cardiol 48:1919–1928

    Article  PubMed  Google Scholar 

  10. Vanhoenacker PK, Heijenbrok-Kal MH, Van Heste R, Decramer I, Van Hoe LR, Wijns W, Hunink MG (2007) Diagnostic performance of multidetector CT angiography for assessment of coronary artery disease: Meta-analysis. Radiology 44:419–428

    Article  Google Scholar 

  11. Raff GJ, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of noninvasive angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46:552–557

    Article  PubMed  Google Scholar 

  12. Leschka S, Wildermuth S, Boehm T, Desbiolles L, Husmann L, Plass A, Koepfli P, Schepis T, Marincek B, Kaufmann PA, Alkadhi H (2006) Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 241:378–385

    Article  PubMed  Google Scholar 

  13. Hoffmann MH, Shi H, Manzke R, Schmid FT, De Vries L, Grass M, Brambs HJ, Aschoff AJ (2005) Noninvasive coronary angiography with 16-detector row CT: effect of heart rate. Radiology 234:86–97

    Article  PubMed  Google Scholar 

  14. Herzog C, Arning-Erb M, Zangos S, Eichler K, Hammerstingl R, Dogan S, Ackermann H, Vogl TJ (2006) Multi-detector row CT coronary angiography: influence of reconstruction technique and heart rate on image quality. Radiology 238(1):75–86, Jan

    Article  PubMed  Google Scholar 

  15. Ghostine S, Caussin C, Daoud B, Habis M, Perrier E, Pesenti-Rossi D, Sigal-Cinqualbre A, Angel CY, Lancelin B, Capderou A, Paul JF (2006) Non-invasive detection of coronary artery disease in patients with left bundle branch block using 64-slice computed tomography. J Am Coll Cardiol 48:1929–1934

    Article  PubMed  Google Scholar 

  16. Wintersperger BJ, Nikolaou K, von Ziegler F, Johnson T, Rist C, Leber A, Flohr T, Knez A, Reiser MF, Becker CR (2006) Image quality, motion artifacts, and reconstruction timing of 64-slice coronary computed tomography angiography with 0.33-second rotation speed. Invest Radiol 41:436–442

    Article  PubMed  Google Scholar 

  17. Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Suss C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Kuttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16:256–268

    Article  PubMed  Google Scholar 

  18. Achenbach S, Ropers D, Kuettner A, Flohr T, Ohnesorge B, Bruder H, Theessen H, Karakaya M, Daniel WG, Bautz W, Kalender WA, Anders K (2006) Contrast-enhanced coronary artery visualization by dual-source computed tomography—initial experience. Eur J Radiol 57:331–335

    Article  PubMed  Google Scholar 

  19. Johnson TR, Krauss B, Sedlmair M, Grasruck M, Bruder H, Morhard D, Fink C, Weckbach S, Lenhard M, Schmidt B, Flohr T, Reiser MF, Becker CR (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517

    Article  PubMed  Google Scholar 

  20. Boll DT, Hoffmann MH, Huber N, Bossert AS, Aschoff AJ, Fleiter TR (2006) Spectral coronary multidetector computed tomography angiography: dual benefit by facilitating plaque characterization and enhancing lumen depiction. J Comput Assist Tomogr 30:804–811

    Article  PubMed  Google Scholar 

  21. Johnson TR, Nikolaou K, Wintersperger BJ, Leber AW, von Ziegler F, Rist C, Buhmann S, Knez A, Reiser MF, Becker CR (2006) Dual-source CT cardiac imaging: initial experience. Eur Radiol 16:1409–1415

    Article  PubMed  Google Scholar 

  22. Leschka S, Scheffel H, Desbiolles L, Plass A, Gaemperli O, Valenta I, Husmann L, Flohr TG, Genoni M, Marincek B, Kaufmann PA, Alkadhi H (2007) Image quality and reconstruction intervals of dual-source CT coronary angiography: recommendations for ECG-pulsing windowing. Invest Radiol 42:543–549

    Article  PubMed  Google Scholar 

  23. McCollough CH, Primak AN, Saba O, Bruder H, Stierstorfer K, Raupach R, Suess C, Schmidt B, Ohnesorge BM, Flohr TG (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784

    Article  PubMed  Google Scholar 

  24. Matt D, Scheffel H, Leschka S, Flohr TG, Marincek B, Kaufmann PA, Alkadhi H (2007) Dual-source CT coronary angiography: image quality, mean heart rate, and heart rate variability. AJR Am J Roentgenol 189:567–573

    Article  PubMed  Google Scholar 

  25. Schertler T, Scheffel H, Frauenfelder T, Desbiolles L, Leschka S, Stolzmann P, Seifert B, Flohr TG, Marincek B, Alkadhi H (2007) Dual-source computed tomography in patients with acute chest pain: feasibility and image quality. Eur Radiol 17:3179–3188

    Article  PubMed  Google Scholar 

  26. Hoffmann U, Moselewski F, Cury RC, Ferencik M, Jang IK, Diaz LJ, Abbara S, Brady TJ, Achenbach S (2004) Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient-versus segment-based analysis. Circulation 110:2638–2643

    Article  PubMed  Google Scholar 

  27. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S (2006) Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. Eur Radiol 16:2739–2747

    Article  PubMed  Google Scholar 

  28. Kuettner A, Beck T, Drosch T, Kettering K, Heuschmid M, Burgstahler C, Claussen CD, Kopp AF, Schroeder S (2005) Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution. J Am Coll Cardiol 45:123–127

    Article  PubMed  Google Scholar 

  29. Oncel D, Oncel G, Tastan A (2007) Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation: Initial experience. Radiology 245:703–711

    Article  PubMed  Google Scholar 

  30. Reimann AJ, Rinck D, Birinci-Aydogan A, Scheuering M, Burgstahler C, Schroeder S, Brodoefel H, Tsiflikas I, Herberts T, Flohr T, Claussen CD, Kopp AF, Heuschmid M (2007) Dual-source computed tomography: advances of improved temporal resolution in coronary plaque imaging. Invest Radiol 42:196–203

    Article  PubMed  Google Scholar 

  31. Mahnken AH, Bruder H, Suess C, Muhlenbruch G, Bruners P, Hohl C, Guenther RW, Wildberger JE (2007) Dual-source computed tomography for assessing cardiac function: a phantom study. Invest Radiol 42:491–498

    Article  PubMed  Google Scholar 

  32. Rist C, Johnson TR, Becker A, Leber AW, Huber A, Busch S, Becker CR, Reiser MF, Nikolaou K (2007) Dual-source cardiac CT imaging with improved temporal resolution: Impact on image quality and analysis of left ventricular function. Radiologe 47:287–290

    Article  PubMed  Google Scholar 

  33. IEC (International Electrotechnical Commission) (1999) Medical electrical equipment - 60601 Part 2–44: Particular requirements for the safety of X-ray equipment for computed tomography. Geneva, Switzerland

  34. Kalender WA, Schmidt B, Zankl M, Schmidt M (1999) A PC program for estimating organ dose and effective dose values in computed tomography. Eur Radiol 9:555–562

    Article  PubMed  CAS  Google Scholar 

  35. Deak P, van Straten M, Shrimpton P, Zankl M, Kalender W (2007) Validation of a Monte Carlo tool for patient-specific dose simulations in multi-slice computed tomography. Eur Radiol Dec 8; [Epub ahead of print] DOI 10.1007/s00330-007-0815-7

  36. Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, Kastrati A, Schömig A (2006) Radiation dose estimates from cardiac multislice computed tomography in daily practice. Circulation 113:1305–1310

    Article  PubMed  Google Scholar 

  37. Stolzmann P, Scheffel H, Schertler T, Frauenfelder T, Leschka S, Husmann L, Flohr TG, Marincek B, Kaufmann PA, Alkadhi H (2007) Radiation dose estimates in dual-source computed tomography coronary angiography. Eur Radiol Oct 2; [Epub ahead of print] DOI 10.1007/s00330-007-0786-8

  38. Coles DR, Smail MA, Negus IS, Wilde P, Oberhoff M, Karsch KR, Baumbach A (2006) Comparison of radiation doses from multislice computed tomography coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol 47:1840–1845

    Article  PubMed  Google Scholar 

  39. Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, Reiser MF (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086

    Article  PubMed  Google Scholar 

  40. Kalender WA, Buchenau S, Kyriakou Y (2007) Optimal choice of X-ray spectra for pediatric and for general CT. Radiological Society of North America, Scientific Assembly and Annual Meeting Program 2007, Chicago, Nov. 24–30, p 268

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Achenbach, S., Anders, K. & Kalender, W.A. Dual-source cardiac computed tomography: image quality and dose considerations. Eur Radiol 18, 1188–1198 (2008). https://doi.org/10.1007/s00330-008-0883-3

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  • DOI: https://doi.org/10.1007/s00330-008-0883-3

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