Madaj Paul, Li Dong, Nakanishi Rine, Andreini Daniele, Pontone Gianluca, Conte Edoardo, O'Rourke Rachael, Hamilton-Craig Christian, Nimmagadda Manojna, Kim Nicholas, Fatima Badiha, Dailing Christopher, Budoff Matthew
Los Angeles Biomedical Research Institute, United States.
Centro Cardiologico Monzino, Italy.
J Nucl Med Technol. 2019 Oct 11. doi: 10.2967/jnumed.119.229500.
Coronary artery disease is the leading cause for morbidity and mortality. Tools have been developed to accurately diagnose and evaluate coronary artery disease. Coronary computed tomographic angiography (CCTA) scans provide detailed imaging along with analysis to in order to deliver precise analysis and prognostic information. We sought to evaluate the radiation doses of the 256 detector CT scanner to a 64 slice scanner across a similar profile of patients. Consecutive patients were screened, enrolled, and consented for the Converge Registry study, in accordance with the Institutional Review Board (IRB) approved protocol. 110 patients underwent CCTA using the GE Revolution 256 detector CT scanner. We matched patients by age, gender and body mass index (BMI) who underwent 64 slice CT scanning. We compared 110 patients in each group. We found that mean dose length product (DLP, presented also in the tables below in millisieverts (mSv)) was significantly lower in the Revolution 256 detector group compared to the 64 slice control group (p<0.05). The radiation dose was reduced 32% with use of Revolution 256 detector scanner for BMI between 18.5 and 24.9 (DL = 111.2 vs 76.1; 1.56 vs 1.07 mSv; p<0.05). For each BMI subgroup, there was a significant decrease in dose. Regression analysis found that with the increase in BMI both scanners experienced a significant increase in DLP. We are able to demonstrate that the 256 slice CT scanner is able to provide CCTA scans at significantly lower radiation doses compared to the 64 row scanner at different BMI groups, with all other variables accounted for. Lower radiation exposures along with lower contrast requirements can provide quality imaging with high diagnostic accuracy and less risk to the patient.
冠状动脉疾病是发病和死亡的主要原因。已经开发出了用于准确诊断和评估冠状动脉疾病的工具。冠状动脉计算机断层血管造影（CCTA）扫描可提供详细的成像及分析，以便提供精确的分析和预后信息。我们试图评估256层探测器CT扫描仪与64层扫描仪对相似患者群体的辐射剂量。根据机构审查委员会（IRB）批准的方案，对连续的患者进行筛查、入组并同意参加Converge注册研究。110例患者使用GE Revolution 256层探测器CT扫描仪进行了CCTA检查。我们根据年龄、性别和体重指数（BMI）对接受64层CT扫描的患者进行匹配。我们比较了每组中的110例患者。我们发现，与64层对照组相比，Revolution 256层探测器组的平均剂量长度乘积（DLP，以下表格中也以毫希沃特（mSv）表示）显著更低（p<0.05）。对于BMI在18.5至24.9之间的患者，使用Revolution 256层探测器扫描仪时辐射剂量降低了32%（DL = 111.2 vs 76.1；1.56 vs 1.07 mSv；p<0.05）。对于每个BMI亚组，剂量均有显著降低。回归分析发现，随着BMI的增加，两种扫描仪的DLP均显著增加。我们能够证明，在考虑所有其他变量的情况下，与64排扫描仪相比，256层CT扫描仪能够以显著更低的辐射剂量进行CCTA扫描。更低的辐射暴露以及更低的造影剂需求能够提供具有高诊断准确性且对患者风险更小的高质量成像。
