Department of Cardiology, Lundquist Institute, Torrance, California.
Departments of Cardiovascular Medicine and Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
J Nucl Med Technol. 2020 Mar;48(1):58-62. doi: 10.2967/jnmt.119.229500.
Coronary artery disease is the leading cause of morbidity and mortality. Tools have been developed to accurately diagnose and evaluate coronary artery disease. Coronary CT angiography (CCTA) provides detailed imaging to deliver precise analysis and prognostic information. We sought to compare the radiation dose from a 256-detector-row CT scanner with that from a 64-detector-row CT scanner across a similar profile of patients. Consecutive patients were screened for the Converge Registry study and, after consenting to be included, were enrolled in accordance with an Institutional Review Board-approved protocol. A control group who underwent 64-row CCTA were matched by age, sex, and body mass index (BMI) with a group who underwent 256-row CCTA. We compared 110 patients in each group. We found that mean dose-length product (DLP) was significantly lower in the 256-row group than in the 64-row group ( < 0.05). The radiation dose was reduced by 32% with use of the 256-row scanner for BMIs of 18.5-24.9 (DLP, 111.2 vs. 76.1 mGy-cm [1.56 vs. 1.07 mSv]; < 0.05). For each BMI subgroup, there was a significant decrease in dose. Regression analysis found that with increasing BMIs, DLP significantly increased for both scanners. The 256-row scanner provided CCTA scans at significantly lower radiation doses than the 64-row scanner in different BMI groups, with all other variables accounted for. Lower radiation exposure along with lower contrast requirements can provide images with high diagnostic accuracy and less risk to the patient.
冠状动脉疾病是发病率和死亡率的主要原因。已经开发出工具来准确诊断和评估冠状动脉疾病。冠状动脉 CT 血管造影（CCTA）提供详细的成像，以提供精确的分析和预后信息。我们旨在比较 256 排 CT 扫描仪与 64 排 CT 扫描仪在相似患者人群中的辐射剂量。连续患者被筛选参加 Converge 注册研究，并在同意纳入后，根据机构审查委员会批准的方案入组。64 排 CCTA 组的对照组通过年龄、性别和体重指数（BMI）与接受 256 排 CCTA 的组相匹配。我们比较了每组 110 例患者。我们发现，256 排组的平均剂量长度乘积（DLP）明显低于 64 排组（<0.05）。对于 BMI 为 18.5-24.9 的患者，使用 256 排扫描仪可将辐射剂量降低 32%（DLP，111.2 与 76.1 mGy-cm [1.56 与 1.07 mSv]；<0.05）。对于每个 BMI 亚组，剂量均显著降低。回归分析发现，随着 BMI 的增加，两种扫描仪的 DLP 均显著增加。在不同 BMI 组中，256 排扫描仪提供的 CCTA 扫描的辐射剂量明显低于 64 排扫描仪，同时考虑了所有其他变量。降低辐射暴露和减少对比剂需求可以提供具有高诊断准确性和对患者风险较低的图像。
