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Low-dose prospectively gated 256-slice coronary computed tomographic angiography

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Abstract

Since the introduction of 64-slice scanners, multidetector computed tomography (MDCT) has experienced a marked increase in adoption for the noninvasive assessment of coronary artery disease, although radiation dose concerns remain. The recent introduction of prospective coronary CT angiography (CCTA) has begun to address these concerns; however, its applicability with existing scanners remains limited to cohorts defined by heart rate, heart rate variability, and body mass index. This paper reviews prospective CCTA, the effect of heart rate and heart rate variability on image quality, and the physiologic basis for selection of optimal prospective imaging windows. We then discuss 256-slice technology and our first 4 months of clinical experience with 256-slice prospective CCTA. Our early clinical results indicate that high-quality, low-dose prospective coronary CTA may be applied to patients with higher heart rates, higher BMI, and with less sensitivity to heart rate variability using 256-slice MDCT.

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Acknowledgments

The authors would like to thank Ronda Bruce for her assistance in the creation of clinical figures and Scott Pohlman, Mani Vembar, and Thomas Ivanc for their contributions in reviewing this paper. Additionally, the authors acknowledge the Washington Hospital Center cardiac CT technologists and nurse for their daily dedication and support.

Conflict of interest

Authors who are not employees of Philips Healthcare (Cleveland, OH, USA) controlled the inclusion of all data and information that might have represented a conflict of interest for the authors who are employees of that company.

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Authors and Affiliations

  1. Department of Medicine (Cardiology), Cardiovascular Research Institute, Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC, 20010, USA

    Wm. Guy Weigold

  2. Computed Tomography Clinical Science, Philips Healthcare, 595 Miner Road, Cleveland, OH, 44143, USA

    Mark E. Olszewski & Matthew J. Walker

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  1. Wm. Guy Weigold
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Correspondence to Wm. Guy Weigold.

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Weigold, W.G., Olszewski, M.E. & Walker, M.J. Low-dose prospectively gated 256-slice coronary computed tomographic angiography. Int J Cardiovasc Imaging 25 (Suppl 2), 217–230 (2009). https://doi.org/10.1007/s10554-009-9439-0

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