Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT: Comparison to two-dimensional echocardiography
Background Electrocardiographic (ECG)–based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective We evaluated the effect of maximal ECG-based tube current reduction on left vent...
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| Veröffentlicht in: | Journal of cardiovascular computed tomography 2011-05, Vol.5 (3), p.149-157 |
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| creator | Nakazato, Ryo, MD, PhD Tamarappoo, Balaji K., MD, PhD Smith, Thomas W., MD Cheng, Victor Y., MD Dey, Damini, PhD Shmilovich, Haim, MD Gutstein, Ariel, MD Gurudevan, Swaminatha, MD Hayes, Sean W., MD Thomson, Louise E.J., MBChB Friedman, John D., MD Berman, Daniel S., MD |
| description | Background Electrocardiographic (ECG)–based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen’s κ value 0.83; 95% confidence interval, 0.76–0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE ( P < 0.0001). Conclusion Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment. |
| doi_str_mv | 10.1016/j.jcct.2011.01.011 |
| format | Article |
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Objective We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen’s κ value 0.83; 95% confidence interval, 0.76–0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE ( P < 0.0001). Conclusion Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.</description><identifier>ISSN: 1934-5925</identifier><identifier>EISSN: 1876-861X</identifier><identifier>DOI: 10.1016/j.jcct.2011.01.011</identifier><identifier>PMID: 21367686</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; California ; Cardiac-Gated Imaging Techniques ; Cardiovascular ; Coronary Angiography - methods ; Dual-source CT ; ECG-based tube current modulation ; Electrocardiography ; Female ; Heart Ventricles - diagnostic imaging ; Humans ; Low radiation ; LV function ; Male ; Middle Aged ; Myocardial Contraction ; Observer Variation ; Predictive Value of Tests ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted ; Regional wall motion ; Reproducibility of Results ; Retrospective Studies ; Stroke Volume ; Tomography, Spiral Computed ; Two-dimensional echocardiography ; Ultrasonography ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Function, Left</subject><ispartof>Journal of cardiovascular computed tomography, 2011-05, Vol.5 (3), p.149-157</ispartof><rights>Society of Cardiovascular Computed Tomography</rights><rights>2011 Society of Cardiovascular Computed Tomography</rights><rights>Copyright © 2011 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-25c78b260ca9a0839110f996b007a1d192cc46472d6db5534eb925a2e0ddfca03</citedby><cites>FETCH-LOGICAL-c410t-25c78b260ca9a0839110f996b007a1d192cc46472d6db5534eb925a2e0ddfca03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S193459251100013X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21367686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakazato, Ryo, MD, PhD</creatorcontrib><creatorcontrib>Tamarappoo, Balaji K., MD, PhD</creatorcontrib><creatorcontrib>Smith, Thomas W., MD</creatorcontrib><creatorcontrib>Cheng, Victor Y., MD</creatorcontrib><creatorcontrib>Dey, Damini, PhD</creatorcontrib><creatorcontrib>Shmilovich, Haim, MD</creatorcontrib><creatorcontrib>Gutstein, Ariel, MD</creatorcontrib><creatorcontrib>Gurudevan, Swaminatha, MD</creatorcontrib><creatorcontrib>Hayes, Sean W., MD</creatorcontrib><creatorcontrib>Thomson, Louise E.J., MBChB</creatorcontrib><creatorcontrib>Friedman, John D., MD</creatorcontrib><creatorcontrib>Berman, Daniel S., MD</creatorcontrib><title>Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT: Comparison to two-dimensional echocardiography</title><title>Journal of cardiovascular computed tomography</title><addtitle>J Cardiovasc Comput Tomogr</addtitle><description>Background Electrocardiographic (ECG)–based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen’s κ value 0.83; 95% confidence interval, 0.76–0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE ( P < 0.0001). Conclusion Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.</description><subject>Adult</subject><subject>Aged</subject><subject>California</subject><subject>Cardiac-Gated Imaging Techniques</subject><subject>Cardiovascular</subject><subject>Coronary Angiography - methods</subject><subject>Dual-source CT</subject><subject>ECG-based tube current modulation</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Low radiation</subject><subject>LV function</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>Observer Variation</subject><subject>Predictive Value of Tests</subject><subject>Radiation Dosage</subject><subject>Radiographic Image Interpretation, Computer-Assisted</subject><subject>Regional wall motion</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Stroke Volume</subject><subject>Tomography, Spiral Computed</subject><subject>Two-dimensional echocardiography</subject><subject>Ultrasonography</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Function, Left</subject><issn>1934-5925</issn><issn>1876-861X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uk1v1DAQjRCIlsIf4IB845RlxkmcBCGkasWXVIkDRerN8tqTroMTL3bS1f4jfiZOUzhwQBrJM9abN_Z7k2UvETYIKN70m17racMBcQNL4KPsHJta5I3Am8cpb4syr1penWXPYuwBqhqheZqdcSxELRpxnv26jJFiHGicmO-Yo25id6kIVs9OBRbo1vpROXZUzrHBT6liajSMetL3RRfUmhzttGfOH_OgjFX3V8ZHYntyVicGMyuXRz8HTWx7_ZZt_XBQwcaEmzybjj43Nr0jrvNI771WwVh_G9Rhf3qePemUi_Ti4bzIvn_8cL39nF99_fRle3mV6xJhynml62bHBWjVKmiKFhG6thU7gFqhwZZrXYqy5kaYXVUVJe2SPooTGNNpBcVF9nrlPQT_c6Y4ycFGTc6pkfwcZVPzqoASRULyFamDjzFQJw_BDiqcJIJcDJK9XAySi0ESlsDU9OqBft4NZP62_HEkAd6tAEqfvLMUZNSWRk3GhqS4NN7-n__9P-3a2XHR_wedKPZJ_qRulCgjlyC_LSuybEiSCQCLm-I3hAG62g</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Nakazato, Ryo, MD, PhD</creator><creator>Tamarappoo, Balaji K., MD, PhD</creator><creator>Smith, Thomas W., MD</creator><creator>Cheng, Victor Y., MD</creator><creator>Dey, Damini, PhD</creator><creator>Shmilovich, Haim, MD</creator><creator>Gutstein, Ariel, MD</creator><creator>Gurudevan, Swaminatha, MD</creator><creator>Hayes, Sean W., MD</creator><creator>Thomson, Louise E.J., MBChB</creator><creator>Friedman, John D., MD</creator><creator>Berman, Daniel S., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110501</creationdate><title>Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT: Comparison to two-dimensional echocardiography</title><author>Nakazato, Ryo, MD, PhD ; Tamarappoo, Balaji K., MD, PhD ; Smith, Thomas W., MD ; Cheng, Victor Y., MD ; Dey, Damini, PhD ; Shmilovich, Haim, MD ; Gutstein, Ariel, MD ; Gurudevan, Swaminatha, MD ; Hayes, Sean W., MD ; Thomson, Louise E.J., MBChB ; Friedman, John D., MD ; Berman, Daniel S., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-25c78b260ca9a0839110f996b007a1d192cc46472d6db5534eb925a2e0ddfca03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>California</topic><topic>Cardiac-Gated Imaging Techniques</topic><topic>Cardiovascular</topic><topic>Coronary Angiography - methods</topic><topic>Dual-source CT</topic><topic>ECG-based tube current modulation</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Low radiation</topic><topic>LV function</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>Observer Variation</topic><topic>Predictive Value of Tests</topic><topic>Radiation Dosage</topic><topic>Radiographic Image Interpretation, Computer-Assisted</topic><topic>Regional wall motion</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Stroke Volume</topic><topic>Tomography, Spiral Computed</topic><topic>Two-dimensional echocardiography</topic><topic>Ultrasonography</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakazato, Ryo, MD, PhD</creatorcontrib><creatorcontrib>Tamarappoo, Balaji K., MD, PhD</creatorcontrib><creatorcontrib>Smith, Thomas W., MD</creatorcontrib><creatorcontrib>Cheng, Victor Y., MD</creatorcontrib><creatorcontrib>Dey, Damini, PhD</creatorcontrib><creatorcontrib>Shmilovich, Haim, MD</creatorcontrib><creatorcontrib>Gutstein, Ariel, MD</creatorcontrib><creatorcontrib>Gurudevan, Swaminatha, MD</creatorcontrib><creatorcontrib>Hayes, Sean W., MD</creatorcontrib><creatorcontrib>Thomson, Louise E.J., MBChB</creatorcontrib><creatorcontrib>Friedman, John D., MD</creatorcontrib><creatorcontrib>Berman, Daniel S., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular computed tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakazato, Ryo, MD, PhD</au><au>Tamarappoo, Balaji K., MD, PhD</au><au>Smith, Thomas W., MD</au><au>Cheng, Victor Y., MD</au><au>Dey, Damini, PhD</au><au>Shmilovich, Haim, MD</au><au>Gutstein, Ariel, MD</au><au>Gurudevan, Swaminatha, MD</au><au>Hayes, Sean W., MD</au><au>Thomson, Louise E.J., MBChB</au><au>Friedman, John D., MD</au><au>Berman, Daniel S., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT: Comparison to two-dimensional echocardiography</atitle><jtitle>Journal of cardiovascular computed tomography</jtitle><addtitle>J Cardiovasc Comput Tomogr</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>5</volume><issue>3</issue><spage>149</spage><epage>157</epage><pages>149-157</pages><issn>1934-5925</issn><eissn>1876-861X</eissn><abstract>Background Electrocardiographic (ECG)–based tube current modulation during cardiac CT reduces radiation exposure but significantly increases noise in parts of the cardiac cycle where tube current is minimized. Objective We evaluated the effect of maximal ECG-based tube current reduction on left ventricular (LV) regional wall motion assessment and ejection fraction (EF) by comparing low-radiation helical dual-source CT (DSCT) to 2-dimensional transthoracic echocardiography (2D-TTE). Methods We studied 83 consecutive patients (15 with prior myocardial infarction) who underwent helically acquired DSCT coronary angiography with maximal ECG-based tube current modulation (low-radiation helical DSCT) and 2D-TTE within a 6-month period (median, 1 day), without any change in clinical status between the studies. In all patients, full tube current was applied only at 70% of the R-R interval, with minimal tube current (4% of maximum) in all other parts of the cardiac cycle. Reduced tube voltage (100 kVp) was combined with the maximal dose modulation in 34 patients. DSCT datasets were evaluated by a blinded, experienced cardiologist. Regional wall motion was assessed with the standard 17-segment model, with each segment scored as normal, hypokinetic, akinetic, and dyskinetic. Results Mean effective radiation dose for the low-radiation helical DSCT was 5.2 ± 1.7 mSv. Regional wall motion was evaluable in all segments on low-radiation helical DSCT. There was excellent agreement of wall motion scoring by low-radiation helical DSCT and 2D-TTE in 1382 of 1411 segments (98%; Cohen’s κ value 0.83; 95% confidence interval, 0.76–0.89; P < 0.0001). Mean LVEF was 67.6% ± 10.3% on low-radiation helical DSCT and 61.8% ± 10.3% on 2D-TTE ( P < 0.0001). Conclusion Low-radiation dose helical coronary CT angiography with maximal ECG-based tube current modulation is comparable to 2D-TTE for regional wall motion and EF assessment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21367686</pmid><doi>10.1016/j.jcct.2011.01.011</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Aged California Cardiac-Gated Imaging Techniques Cardiovascular Coronary Angiography - methods Dual-source CT ECG-based tube current modulation Electrocardiography Female Heart Ventricles - diagnostic imaging Humans Low radiation LV function Male Middle Aged Myocardial Contraction Observer Variation Predictive Value of Tests Radiation Dosage Radiographic Image Interpretation, Computer-Assisted Regional wall motion Reproducibility of Results Retrospective Studies Stroke Volume Tomography, Spiral Computed Two-dimensional echocardiography Ultrasonography Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - physiopathology Ventricular Function, Left |
| title | Assessment of left ventricular regional wall motion and ejection fraction with low-radiation dose helical dual-source CT: Comparison to two-dimensional echocardiography |
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