Coronary Computed Tomography Angiography Using an Optimal Acquisition Time Window Based on Heart Rate Determined During Breath-Holding Following Free Breathing.

OBJECTIVES

To compare the image quality and radiation dose in coronary computed tomography angiography (CCTA) based on different acquisition time windows corresponding to the heart rate of breath-holding after free breathing.

METHODS

Two hundred patients who underwent CCTA with a basal heart rate between 70 and 85 beats/min were divided into groups A and B, with 100 patients in each group. Patients in groups A and B were scanned with the acquisition time window corresponding to the heart rate determined during a breath hold obtained after free breathing and the basal heart rate during free breathing, respectively. Computed tomography (CT) attenuation values of the coronary artery, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated. The subjective image scores of the groups were assessed blindly by 2 experienced physicians using a 4-point system, and score consistency was compared using the κ test. The volume CT dose index and dose-length product were recorded for each patient, and the effective dose (ED) was calculated. The Kruskal-Wallis H test was performed to evaluate differences in age, heart rate, and body mass index. A χ2 test was used to evaluate sex differences. An independent-sample t test was employed to compare objective and subjective data such as dose-length product, volume CT dose index, ED, SNR, CNR, and averaged subjective assessment scores. Statistical significance was set at P  < 0.05.

RESULTS

No statistically significant differences occurred in sex, age, or body mass index between patients in group A and group B (all P  > 0.05). No significant differences occurred in the mean CT values, mean SNR values, mean CNR values, or mean subjective scores of CCTA images between the patients in groups A and B ( P  > 0.05). The ED values of the patients in group A were 52.93% lower than those in group B ( P  < 0.001).

CONCLUSION

The radiation dose in CCTA examinations can be significantly reduced while maintaining image quality by narrowing the acquisition time window for breath-holding after free breathing.