Diagnostic performance of two types of low radiation exposure protocol for prospective ECG-triggering multidetector computed tomography angiography in assessment of coronary artery bypass graft

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Abstract

Background: Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries. Methods: One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT. Results: MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100%, 98.4%, 96.7%, 100% and 98.9%, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100%. Effective radiation dose was 3.5 ± 1.4 mSv in Group 1 vs. 7.4 ± 2.6 mSv in Group 2 vs. 27.8 ± 9.4 mSv in Group 3. Conclusions: Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.

Original languageEnglish
Pages (from-to)63-69
Number of pages7
JournalInternational Journal of Cardiology
Volume157
Issue number1
DOIs
Publication statusPublished - May 17 2012

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Multidetector Computed Tomography
Coronary Artery Bypass
Electrocardiography
Transplants
Coronary Angiography
Computed Tomography Angiography
Radiation Exposure
Coronary Vessels
Pathologic Constriction
Radiation
Sensitivity and Specificity

Keywords

  • Coronary artery bypass graft
  • Multidetector computed tomography
  • Radiation dose exposure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{2a73f2c08cd84e9ea3435f9beedd874d,
title = "Diagnostic performance of two types of low radiation exposure protocol for prospective ECG-triggering multidetector computed tomography angiography in assessment of coronary artery bypass graft",
abstract = "Background: Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries. Methods: One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT. Results: MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100{\%}, 98.4{\%}, 96.7{\%}, 100{\%} and 98.9{\%}, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100{\%}. Effective radiation dose was 3.5 ± 1.4 mSv in Group 1 vs. 7.4 ± 2.6 mSv in Group 2 vs. 27.8 ± 9.4 mSv in Group 3. Conclusions: Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.",
keywords = "Coronary artery bypass graft, Multidetector computed tomography, Radiation dose exposure",
author = "Daniele Andreini and Gianluca Pontone and Saima Mushtaq and Andrea Annoni and Alberto Formenti and Erika Bertella and Alessandro Parolari and Piergiuseppe Agostoni and Antonio Bartorelli and Giovanni Ballerini and Cesare Fiorentini and Mauro Pepi",
year = "2012",
month = "5",
day = "17",
doi = "10.1016/j.ijcard.2010.11.015",
language = "English",
volume = "157",
pages = "63--69",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "1",

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TY - JOUR

T1 - Diagnostic performance of two types of low radiation exposure protocol for prospective ECG-triggering multidetector computed tomography angiography in assessment of coronary artery bypass graft

AU - Andreini, Daniele

AU - Pontone, Gianluca

AU - Mushtaq, Saima

AU - Annoni, Andrea

AU - Formenti, Alberto

AU - Bertella, Erika

AU - Parolari, Alessandro

AU - Agostoni, Piergiuseppe

AU - Bartorelli, Antonio

AU - Ballerini, Giovanni

AU - Fiorentini, Cesare

AU - Pepi, Mauro

PY - 2012/5/17

Y1 - 2012/5/17

N2 - Background: Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries. Methods: One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT. Results: MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100%, 98.4%, 96.7%, 100% and 98.9%, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100%. Effective radiation dose was 3.5 ± 1.4 mSv in Group 1 vs. 7.4 ± 2.6 mSv in Group 2 vs. 27.8 ± 9.4 mSv in Group 3. Conclusions: Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.

AB - Background: Multidetector computed tomography (MDCT) is useful in evaluation of coronary artery bypass graft (CABG). However, radiation exposure is a reason for concern. We compared diagnostic performance and effective dose of a new dedicated post-processing reconstruction algorithm with BMI-adapted scanning protocol (MDCT-XTe) vs. standard prospective ECG-triggering protocol (MDCT-XT) and retrospective ECG-triggering (MDCT-Helical), compared to invasive coronary angiography (ICA), in the assessment of grafts and nongrafted or distal runoff coronary arteries. Methods: One hundred and nineteen patients with 277 grafts were randomized to Group 1 based on BMI-adapted scanning protocol with prospective ECG-triggering (40 patients), Group 2 with prospective ECG-triggering (39 patients) and Group 3 (40 patients) with retrospective ECG-triggering. Data were acquired using 64-slice MDCT. Results: MDCT correctly assessed the patency of all CABG in 3 groups. After comparison with ICA, MDCT was able to correctly detect the occlusion or stenosis of CABG in all groups, with the exception of one case of Group 3. In Group 3 sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CABG evaluation were 100%, 98.4%, 96.7%, 100% and 98.9%, respectively. In Groups 1 and 2 the diagnostic accuracy of CABG evaluation was 100%. Effective radiation dose was 3.5 ± 1.4 mSv in Group 1 vs. 7.4 ± 2.6 mSv in Group 2 vs. 27.8 ± 9.4 mSv in Group 3. Conclusions: Our results indicated that MDCT-XTe and MDCT-XT have a diagnostic performance in the evaluation of CABG similar to MDCT-Helical, with a significant reduction of radiation exposure, specially for MDCT-XTe.

KW - Coronary artery bypass graft

KW - Multidetector computed tomography

KW - Radiation dose exposure

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U2 - 10.1016/j.ijcard.2010.11.015

DO - 10.1016/j.ijcard.2010.11.015

M3 - Article

VL - 157

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EP - 69

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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