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Multidetector Computed Tomography for Coronary Stents Imaging: High-Voltage (140-kVp) Prospective ECG-Triggered Versus Standard-Voltage (120-kVp) Retrospective ECG-Gated Helical Scanning

Esposito, Antonio MD*†; Colantoni, Caterina MD*†; De Cobelli, Francesco MD*†; Del Vecchio, Antonella HP; Palmisano, Anna MD*†; Calandrino, Riccardo HP; Del Maschio, Alessandro MD*†

Journal of Computer Assisted Tomography: May/June 2013 - Volume 37 - Issue 3 - p 395–401
doi: 10.1097/RCT.0b013e3182873559
Cardiovascular Imaging

Objective: To compare prospective electrocardiogram (ECG)-triggered high-voltage coronary computed tomography (CT) angiography (CTA; 140-kVp P-cCTA) with retrospective ECG-gated standard-voltage cCTA (120-kVp R-cCTA), in patients with coronary stents.

Methods: Fifty-two patients with coronary stents were studied with 64-slice multidetector scanner. Ninety-three stents were analyzed: 55 with 140-kVp P-cCTA and 38 with 120-kVp R-cCTA. Image quality (IQ), diagnostic confidence (DC), in-stent assessable lumen, artificial narrowing, and effective radiation dose were compared between techniques.

Results: Image quality and DC were significantly better for the 140-kVp P-cCTA in comparison with the 120-kVp R-cCTA (IQ, 1.1 ± 0.36 vs 1.7 ± 0.60, respectively; P < 0.00001. Diagnostic confidence: 1.1 ± 0.29 vs 1.5 ± 0.65 respectively; P < 0.0001). In-stent assessable lumen and artificial narrowing were comparable between the techniques. Effective dose was lower for the 140-kVp P-cCTA (6.7 ± 2.07 mSv vs 15.8 ± 6.89 mSv; P < 0.0001).

Conclusions: High voltage combined with axial prospective ECG-triggered scan improved IQ and DC in stent cCTA imaging but failed to improve the diameter of in-stent assessable lumen and to reduce the artificial narrowing compared with the 120-kVp R-cCTA. Effective dose was 60% lower for the 140-kVp P-cCTA.

From the *Department of Radiology and Experimental Imaging Center, San Raffaele Scientific Institute and Vita-Salute University; and †Medical Physics Service, San Raffaele Scientific Institute, Milan, Italy.

Received for publication October 20, 2012; accepted January 10, 2013.

Reprints: Antonio Esposito, MD, Department of Radiology and Experimental Imaging Center, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy (e-mail: esposito.antonio@hsr.it).

The authors have no conflict of interest to report.

© 2013 by Lippincott Williams & Wilkins