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Coronary CT angiography performed by the novel whole organ volumetric high definition CT scanner in patients with atrial fibrillation

Session Poster session 6

Speaker Edoardo Conte

Event : ESC Congress 2016

  • Topic : imaging
  • Sub-topic : Computed Tomography
  • Session type : Poster Session

Authors : S Mushtaq (Milan,IT), E Conte (Milan,IT), V Volpato (Milan,IT), C Agalbato (Milan,IT), M Guglielmo (Milan,IT), A Baggiano (Milan,IT), A Formenti (Milan,IT), A Annoni (Milan,IT), M Pepi (Milan,IT), AL Bartorelli (Milan,IT), C Fiorentini (Milan,IT), G Pontone (Milan,IT), D Andreini (Milan,IT)

S. Mushtaq1 , E. Conte1 , V. Volpato1 , C. Agalbato1 , M. Guglielmo1 , A. Baggiano1 , A. Formenti1 , A. Annoni1 , M. Pepi1 , A.L. Bartorelli2 , C. Fiorentini2 , G. Pontone1 , D. Andreini2 , 1Cardiology Center Monzino IRCCS - Milan - Italy , 2University of Milan, Foundation Monzino (IRCCS), Center Cardiology, Dpt of Cardiology - Milan - Italy ,

European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 1050-1051

Objectives: To evaluate the image quality, coronary interpretability and radiation exposure of coronary CT angiography (CCTA) performed with a newest generation of cardiac-CT scanner in patients with atrial fibrillation (AF).

Background: Despite the relevant improvement in the CT temporal resolution that characterizes the last scanner generation, the evaluation of coronary arteries by CCTA in patients with AF remains the more challenging application of cardiac-CT, particularly in patients with heart rate (HR) >75 bpm. Moreover, the radiation exposure associated with CT is still very high in this clinical subset.

Materials and methods: 49 patients (30 males, mean age 71,5±7,3 years old) with chronic AF undergoing CCTA for suspected CAD by using a novel whole organ volumetric high definition CT scanner (16cm z-axis coverage with 256 detector rows and 512 slices, gantry rotation time 0.28 sec), were enrolled in the study. Prospective ECG-triggering was used in all patients, of whom 20 with double-shot technique and the remaining 29 with single-shot technique. In all patients, image quality score (by a 4-point Likert scale on a per-segment level) and coronary interpretability were evaluated and the effective dose (ED) was recorded.

Results: The mean HR during the scan was 87.7±22 bpm. The overall image quality was very high (Likert=3.4±1.2, excellent image quality=451 segments, good=206 segments, adequate=90 segments, poor/non diagnostic=19 segments). The overall coronary interpretability was 97.5% (747/766 segments); in patients performed with double-shot technique, the interpretability was 96.4%, whereas we found an interpretability of 98.4% with single-shot technique. The overall mean ED was 4.6±2.1 mSv, while a significantly lower dose (3.6±1.5 mSv) was measured for single-shot technique vs. double-shot approach (5.9±2.1 mSv, p<0.01).

Conclusions: The novel whole organ high definition CT scanner allows to evaluate coronary arteries with high image quality and coronary interpretability and low radiation exposure in patients with atrial fibrillation and high HR during the scan.

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