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Eur Radiol. 2019 May;29(5):2218-2225. doi: 10.1007/s00330-018-5752-0. Epub 2018 Nov 12.

Clinical feasibility of catheter-directed selective intracoronary computed tomography angiography using an extremely low dose of iodine in patients with coronary artery disease.

Author information

1
Brain Korea 21 Project for Medical Science, Yonsei University, Seoul, South Korea.
2
Division of Cardiology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Gangneung, South Korea.
3
Division of Cardiology, Department of Internal Medicine, Heart Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
4
Graduate School of Biomedical Engineering, Yonsei University College of Medicine, Seoul, South Korea.
5
Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
6
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, Seoul, 120-752, South Korea.
7
Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, Seoul, 120-752, South Korea. hjchang@yuhs.ac.
8
Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. hjchang@yuhs.ac.

Abstract

OBJECTIVE:

This study aimed to evaluate the clinical feasibility of catheter-directed selective computed tomography angiography (S-CTA) in patients with coronary artery disease (CAD).

METHODS:

We prospectively enrolled 65 patients diagnosed with CAD who underwent conventional computed tomography angiography (C-CTA). C-CTA was performed with 60-90 mL of contrast medium (370 mg iodine/mL), whereas S-CTA was performed with 15 mL of contrast medium and 17.19 mg iodine/mL. Luminal enhancement range, homogeneity of luminal enhancement, image quality, plaque volume (PV), and percent aggregate plaque volume (%APV) were measured. Paired Student's t test, Wilcoxon rank-sum test, and Pearson's correlation coefficient were used to compare two methods.

RESULTS:

Luminal enhancement was significantly higher on S-CTA than on C-CTA (324.4 ± 8.0 Hounsfield unit (HU) vs. 312.0 ± 8.0 HU, p < 0.0001 in the per-vessel analysis). Transluminal attenuation gradient showed a significantly slower reduction pattern on S-CTA than on C-CTA (-0.65 HU/10 mm vs. -0.89 HU/10 mm, p < 0.0001 in the per-vessel analysis). Image noise was significantly lower on S-CTA than on C-CTA (39.6 ± 10.0 HU vs. 43.9 ± 9.4 HU, p < 0.0001). There was excellent correlation between S-CTA and C-CTA with respect to PV and %APV (r = 0.99, r = 0.98, respectively).

CONCLUSIONS:

S-CTA might be useful in facilitating atherosclerotic plaque analysis and providing guidance for complex lesions such as chronic total occlusion, particularly in cases in which on-site procedure planning is required.

KEY POINTS:

• Selective computed tomography angiography (S-CTA) can serve as an intraprocedural computed tomography angiography protocol. • S-CTA was performed with low dose of iodine compared with conventional computed tomography angiography. • S-CTA enables on-site atherosclerotic plaque analysis.

KEYWORDS:

Atherosclerotic plaque; Cardiac imaging technique; Contrast media; Coronary angiography; Coronary arteries

PMID:
30421011
DOI:
10.1007/s00330-018-5752-0
[Indexed for MEDLINE]

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