Comments on: Noninvasive Coronary Angiography by 320-Row Computed Tomography with Lower Radiation Exposure and Maintained Diagnostic Accuracy: Comparison of Results with Cardiac Catheterization in a Head-to-Head Pilot Investigation

By: Paul Schoenhagen, MD

Paul Schoenhagen, MD — Wed, 03 Feb 2010 21:03:23 +0000

Also see the recent article:

Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease.
de Graaf FR, Schuijf JD, van Velzen JE, Kroft LJ, de Roos A, Reiber JH, Boersma E, Schalij MJ, Spanó F, Jukema JW, van der Wall EE, Bax JJ.
Eur Heart J. 2010 Jan 4.
PMID: 20047991

By: Jacobo Kirsch, MD

Jacobo Kirsch, MD — Wed, 04 Nov 2009 03:49:12 +0000

Interesting study that shows, hidden among other findings, that there were NO un-interpretable coronary segments on CTA – all 466 segments analyzed were interpretable! However, the need for heart rates below 65 bpm was still pursued (if not always necessarily achieved). While there is no table movement in the z-position, the gantry rotation time is slower than ideal to eliminate the need of rate-control medications (even slower than some 64 row MDCT scanners in the market).

A very interesting finding was the significant dose reduction of CTA when compared to conventional coronary angiography. But when the patients were grouped by heart rate, those with rates above 65 bpm showed a median exposure dose of 12.3 mSv (similar as to what some patients may receive during CTA examinations using 64 row MDCT scanners).

I cannot claim to have experience with this technology. So I ask: is it necessary to scan patients with the mAs doses used in this study? To me they seem slightly elevated.

By: Paul Schoenhagen, MD

Paul Schoenhagen, MD — Sun, 01 Nov 2009 19:07:50 +0000

This scanner allows imaging of the heart with one table position.
See also:
Initial evaluation of coronary images from 320-detector row computed tomography.
Rybicki FJ, Otero HJ, Steigner ML, et al.
Int J Cardiovasc Imaging. 2008 Jun;24(5):535-46.
PMID: 18368512