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Erschienen in: Wiener klinische Wochenschrift 13-14/2016

01.07.2016 | original article

Diagnostic accuracy and effective radiation dose of high pitch dual source multidetector computed tomography in evaluation of coronary artery bypass graft patency

verfasst von: Mustafa Koplay, M.D., Serkan Guneyli, Hakan Akbayrak, Kenan Demir, Mesut Sivri, Ahmet Avci, Hasan Erdogan, Yahya Paksoy

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 13-14/2016

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Summary

Objective

The aim of the study was to evaluate the diagnostic accuracy and effective radiation dose (ERD) of high pitch dual source multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency.

Materials and methods

Fourty-five patients who underwent 128 × 2‑slice MDCT angiography with a prospective electrocardiogram-triggering, low-dose, high pitch, dual source, flash spiral acquisition mode after CABG surgery were included in the study. The interobserver agreement of the image quality was evaluated with Cohen κ value. The image quality was compared to the heart rates (HRs) using Mann–Whitney U test and to the graft segments using χ2 test. The findings for the CABG patency on MDCT were compared to those determined on catheter coronary angiography. Dose-length product (DLP) and ERD were compared to the gender, HRs, and body mass index (BMI) of the patients using Kruskall Wallis and Mann–Whitney U tests.

Results

A total of 110 grafts and 330 vessel segments were evaluated with a good interobserver agreement (κ = 0.80). The image quality was better in proximal and middle graft segments (p < 0.05), as well as in the patients with low HRs (p < 0.05). High pitch MDCT had the following sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for evaluation of graft patency: 92.8, 99.3, 92.8, 99.3 and 98.8 %, respectively. ERD was correlated to the HRs and BMI.

Conclusions

High pitch 128 × 2‑slice dual source CT angiography is a noninvasive imaging modality, and it can be safely and effectively used in evaluation of CABG patency with lower radiation dose.
Literatur
1.
Zurück zum Zitat Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, et al. ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol. 1999;33:1756–824.CrossRefPubMed Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, et al. ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol. 1999;33:1756–824.CrossRefPubMed
2.
Zurück zum Zitat Laspas F, Roussakis A, Kritikos N, Mourmouris C, Efthimiadou R, Andreou J. Imaging of coronary arter bypass grafts by computed tomography coronary angiography. Curr Probl Diagn Radiol. 2013;42:241–8.CrossRefPubMed Laspas F, Roussakis A, Kritikos N, Mourmouris C, Efthimiadou R, Andreou J. Imaging of coronary arter bypass grafts by computed tomography coronary angiography. Curr Probl Diagn Radiol. 2013;42:241–8.CrossRefPubMed
3.
Zurück zum Zitat Gerber TC, Carr JJ, Arai AE, Dixon RL, Ferrari VA, Gomes AS, et al. Ionizing radiation in cardiac imaging: a science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation. 2009;19:1056–65.CrossRef Gerber TC, Carr JJ, Arai AE, Dixon RL, Ferrari VA, Gomes AS, et al. Ionizing radiation in cardiac imaging: a science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation. 2009;19:1056–65.CrossRef
4.
Zurück zum Zitat Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–23.CrossRefPubMed Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–23.CrossRefPubMed
5.
6.
Zurück zum Zitat Leschka S, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Schertler T, et al. Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Eur Radiol. 2009;19:896–903.CrossRef Leschka S, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Schertler T, et al. Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Eur Radiol. 2009;19:896–903.CrossRef
7.
Zurück zum Zitat Sommer WH, Albrecht E, Bamberg F, Schenzle JC, Johnson TR, Neumaier K, et al. Feasibility and radiation dose of high-pitch acquisition protocols in patients undergoing dual-source cardiac CT. AJR Am J Roentgenol. 2010;195:1306–12.CrossRefPubMed Sommer WH, Albrecht E, Bamberg F, Schenzle JC, Johnson TR, Neumaier K, et al. Feasibility and radiation dose of high-pitch acquisition protocols in patients undergoing dual-source cardiac CT. AJR Am J Roentgenol. 2010;195:1306–12.CrossRefPubMed
8.
Zurück zum Zitat Meyer M, Schoepf J, Fink C, Hlavacek AM, Henzler T. Progressive intra-individual radiation dose reduction during CT surveillance of a patient with ALCAPA syndrome. Diagn Interv Radiol. 2012;18:547–51.PubMed Meyer M, Schoepf J, Fink C, Hlavacek AM, Henzler T. Progressive intra-individual radiation dose reduction during CT surveillance of a patient with ALCAPA syndrome. Diagn Interv Radiol. 2012;18:547–51.PubMed
9.
Zurück zum Zitat Alkadhi H, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Plass A, et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010;96:933–8.CrossRefPubMed Alkadhi H, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Plass A, et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010;96:933–8.CrossRefPubMed
10.
Zurück zum Zitat Andre F, Korosoglou G, Hosch W, Giannitsis E, Kauczor HU, Katus HA, et al. Performance of source versus 256-slice multi-slice CT in the evaluation of 16 coronary artery stents. Eur J Radiol. 2013;82:601–7.CrossRefPubMed Andre F, Korosoglou G, Hosch W, Giannitsis E, Kauczor HU, Katus HA, et al. Performance of source versus 256-slice multi-slice CT in the evaluation of 16 coronary artery stents. Eur J Radiol. 2013;82:601–7.CrossRefPubMed
11.
Zurück zum Zitat College Park M. The measurement, reporting and management of radiation dose in CT: report of AAPM Task Group 23 of the diagnostic imaging council CT committee. AAPM Rep. 2008;13:96. College Park M. The measurement, reporting and management of radiation dose in CT: report of AAPM Task Group 23 of the diagnostic imaging council CT committee. AAPM Rep. 2008;13:96.
12.
Zurück zum Zitat Chartrand-Lefebvre C. Stepladder artifact in coronary computed tomography angiography. Catheter Cardiovasc Interv. 2007;69:922.CrossRefPubMed Chartrand-Lefebvre C. Stepladder artifact in coronary computed tomography angiography. Catheter Cardiovasc Interv. 2007;69:922.CrossRefPubMed
13.
Zurück zum Zitat Rau NH, Rau P, Chin AS, Provost Y, Stevens LM, Noiseux N, et al. Coronary artery bypass graft imaging with 256-slice MDCT: surgical concepts, current techniques, and interpretation. Clin Imaging. 2014;38:571–9.CrossRefPubMed Rau NH, Rau P, Chin AS, Provost Y, Stevens LM, Noiseux N, et al. Coronary artery bypass graft imaging with 256-slice MDCT: surgical concepts, current techniques, and interpretation. Clin Imaging. 2014;38:571–9.CrossRefPubMed
14.
Zurück zum Zitat Yuceler Z, Kantarci M, Yuce I, Kizrak Y, Bayraktutan U, Ogul H, et al. Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings. J Comput Assist Tomogr. 2014;38:61–6.CrossRefPubMed Yuceler Z, Kantarci M, Yuce I, Kizrak Y, Bayraktutan U, Ogul H, et al. Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings. J Comput Assist Tomogr. 2014;38:61–6.CrossRefPubMed
15.
Zurück zum Zitat Lee YW, Yang CC, Mok GS, Law WY, Su CT, Wu TH. Prospectively versus retrospectively ECG-gated 256-slice CT angiography to assess coronary artery by-pass grafts-comparison of image quality and radiation dose. PLoS ONE. 2012;7:e49212.CrossRefPubMedPubMedCentral Lee YW, Yang CC, Mok GS, Law WY, Su CT, Wu TH. Prospectively versus retrospectively ECG-gated 256-slice CT angiography to assess coronary artery by-pass grafts-comparison of image quality and radiation dose. PLoS ONE. 2012;7:e49212.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Goetti R, Leschka S, Baumüller S, Plass A, Wieser M, Desbiolles L, et al. Low dose high-pitch spiral acquisition 128-slice dual-source computed tomography for the evaluation of coronary artery by-pass graft patency. Invest Radiol. 2010;45:324–30.PubMed Goetti R, Leschka S, Baumüller S, Plass A, Wieser M, Desbiolles L, et al. Low dose high-pitch spiral acquisition 128-slice dual-source computed tomography for the evaluation of coronary artery by-pass graft patency. Invest Radiol. 2010;45:324–30.PubMed
17.
Zurück zum Zitat Feuchtner GM, Schacner T, Bonatti J, Friedrich GJ, Soegner P, Klauser A, et al. Diagnostic performance of 64-slice computed tomography in evaluation of coronary artery bypass grafts. AJR Am J Roentgenol. 2007;189:574–80.CrossRefPubMed Feuchtner GM, Schacner T, Bonatti J, Friedrich GJ, Soegner P, Klauser A, et al. Diagnostic performance of 64-slice computed tomography in evaluation of coronary artery bypass grafts. AJR Am J Roentgenol. 2007;189:574–80.CrossRefPubMed
18.
Zurück zum Zitat Hamon M, Lepage O, Malagutti P, Riddell JW, Morello R, Agostini D, et al. Diagnostic performance of 16- and 64-section spiral CT for coronary artery bypass graft assessment: meta-analysis. Radiology. 2008;247:679–86.CrossRefPubMed Hamon M, Lepage O, Malagutti P, Riddell JW, Morello R, Agostini D, et al. Diagnostic performance of 16- and 64-section spiral CT for coronary artery bypass graft assessment: meta-analysis. Radiology. 2008;247:679–86.CrossRefPubMed
19.
Zurück zum Zitat Nepveu S, Stevens LM, Chartrand-Lefebvre C. Iterative reconstruction in 256-slice computed tomography angiography of coronary artery bypass grafts – assessment of radiation dose reduction and image quality. AJR Am J Roentgenol. 2014;202:W599.CrossRefPubMed Nepveu S, Stevens LM, Chartrand-Lefebvre C. Iterative reconstruction in 256-slice computed tomography angiography of coronary artery bypass grafts – assessment of radiation dose reduction and image quality. AJR Am J Roentgenol. 2014;202:W599.CrossRefPubMed
20.
Zurück zum Zitat Kantarci M, Doğanay S, Karçaaltıncaba M, Karabulut N, Erol MK, Yalcin A, et al. Clinical situations in which coronary CT angiography confers superior diagnostic information compared with coronary angiography. Diagn Interv Radiol. 2012;18:261–9.PubMed Kantarci M, Doğanay S, Karçaaltıncaba M, Karabulut N, Erol MK, Yalcin A, et al. Clinical situations in which coronary CT angiography confers superior diagnostic information compared with coronary angiography. Diagn Interv Radiol. 2012;18:261–9.PubMed
Metadaten
Titel
Diagnostic accuracy and effective radiation dose of high pitch dual source multidetector computed tomography in evaluation of coronary artery bypass graft patency
verfasst von
Mustafa Koplay, M.D.
Serkan Guneyli
Hakan Akbayrak
Kenan Demir
Mesut Sivri
Ahmet Avci
Hasan Erdogan
Yahya Paksoy
Publikationsdatum
01.07.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 13-14/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-016-1030-9

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