Assessment of radiation dose in cardiac CT angiography using retrospective ECG gating technique at Ramathibodi Hospital

Saifhon  Admontree; Sawwanee  Asavaphatiboon; Napapong  Pongnapang; Anchali  Krisanachinda

Authors

Saifhon Admontree Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Sawwanee Asavaphatiboon Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Napapong Pongnapang Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
Anchali Krisanachinda Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Spectral detector CT, 320-detector CT, radiation dose, cardiac CT Angiography, retrospective ECG gating technique

Abstract

Background: The value of 320-detector CT is the volumetric imaging of the entire heart in a single heartbeat per one gantry rotation. The 64-detector- based spectral detector computed tomography (SDCT) uses two layers of detectors to concomitantly accumulate high and low energy data that differentiate materials of different effective atomic numbers. The Cardiac CT Angiography (CTA) has become a reliable diagnostic noninvasive modality used for evaluating the coronary artery disease, along with the advances of CT technology; they need to be concerned in radiation dose.

Objectives: The purpose of this study was to evaluate the radiation dose and establishing local Diagnostic Reference Levels (DRLs) in Cardiac CT Angiography between wide beam detector (320-detector CT) and 64- spectral detector CT (SDCT) using retrospective ECG gating technique.

Methods: A retrospective consecutively analysis of Cardiac CTA by retrospective ECG gating technique in 83 patients from 320-detector CT and 22 patients from spectral detector CT were evaluated. In the105 patients, there were 43 males and 62 females; their age ranged 16 - 91 years, mean age 64.5 $gif.latex?\pm$ 11.8 years, and average body mass index (BMI) was 26.77 kg/m2. Conversion factor (f = 0.014 mSv/mGy.cm) was applied to estimate the effective dose (E) from dose length product (DLP) in this study.

Results: Mean of CTDI_vol (mGy), DLP (mGy.cm) and effective dose (mSv) of calcium scoring for 320-detector were: 8.1 $gif.latex?\pm$ 3.2, 118.9 $gif.latex?\pm$ 48.3, 1.7 $gif.latex?\pm$ 0.7; and the 75^th percentile values were:10.7, 148.1, 2.1; and Cardiac CTA using retrospective ECG gating technique (in average z-axis coverage of 15 $gif.latex?\pm$ 1.2 cm) were: mean 35.1 $gif.latex?\pm$ 37 / 468.1 $gif.latex?\pm$ 303.9/ 6.6 $gif.latex?\pm$ 4.3, the 75^th percentile values 39.3/579.3/8.1. For 64-SDCT (in average z-axis overage of 13.8 $gif.latex?\pm$ 1.3 cm), the mean CTDI_vol/ DLP/ effective dose of calcium scoring were: 4.2 $gif.latex?\pm$ 0/57.5 $gif.latex?\pm$ 5.8/0.8 $gif.latex?\pm$ 0.08; and, the 75^th percentile values were: 4.2/58.8/0.8; Cardiac CTA were: 45.7 $gif.latex?\pm$ 11.8/785.1 $gif.latex?\pm$ 235/11.1 $gif.latex?\pm$ 13.2 and the 75^th percentile values were 52.6/879.7/12.0. Coronary artery bypass graft evaluation was routinely performed on 320-detector CT. As the results of average z- axis coverage was 36.6 cm, leading to highly mean and 75th percentile of CTDI_vol/ DLP/ effective dose were as follows: 28.2 $gif.latex?\pm$ 12.5/1068.8 $gif.latex?\pm$ 513.8/15 $gif.latex?\pm$ 7.2, 30.7/1375.6,19.3 mGy/mGy.cm/mSv, respectively.

Conclusions: The radiation dose was significantly lower in Cardiac CTA using retrospective ECG gating technique patients who underwent 320-detector CT although the mean z-axis coverage is larger than 64-spectral detector CT. Due to 320-detector CT enable volumetric imaging of entire heart within one cardiac cycle and 100 kV_p has been used. While as 64-spectral detector CT 120 kV_p has been used for dual energy and several heartbeats acquired to capture the entire heart.

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Assessment of radiation dose in cardiac CT angiography using retrospective ECG gating technique at Ramathibodi Hospital

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