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Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment

OBJECTIVES: Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. METHODS: Patients with a PHV were scanned using...

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Autores principales: Faure, Marguerite E., Swart, Laurens E., Dijkshoorn, Marcel L., Bekkers, Jos A., van Straten, Marcel, Nieman, Koen, Parizel, Paul M., Krestin, Gabriel P., Budde, Ricardo P. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882630/
https://www.ncbi.nlm.nih.gov/pubmed/29234912
http://dx.doi.org/10.1007/s00330-017-5163-7
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author Faure, Marguerite E.
Swart, Laurens E.
Dijkshoorn, Marcel L.
Bekkers, Jos A.
van Straten, Marcel
Nieman, Koen
Parizel, Paul M.
Krestin, Gabriel P.
Budde, Ricardo P. J.
author_facet Faure, Marguerite E.
Swart, Laurens E.
Dijkshoorn, Marcel L.
Bekkers, Jos A.
van Straten, Marcel
Nieman, Koen
Parizel, Paul M.
Krestin, Gabriel P.
Budde, Ricardo P. J.
author_sort Faure, Marguerite E.
collection PubMed
description OBJECTIVES: Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. METHODS: Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP). RESULTS: We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43). CONCLUSION: Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose. KEY POINTS: • Prosthetic heart valve dysfunction is a potentially life-threatening condition. • Dual-source CT can adequately assess valve leaflet motion and anatomy. • We assessed a comprehensive protocol with three acquisitions for PHV evaluation. • This protocol is associated with good image quality and limited dose.
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spelling pubmed-58826302018-04-05 Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment Faure, Marguerite E. Swart, Laurens E. Dijkshoorn, Marcel L. Bekkers, Jos A. van Straten, Marcel Nieman, Koen Parizel, Paul M. Krestin, Gabriel P. Budde, Ricardo P. J. Eur Radiol Cardiac OBJECTIVES: Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. METHODS: Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP). RESULTS: We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43). CONCLUSION: Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose. KEY POINTS: • Prosthetic heart valve dysfunction is a potentially life-threatening condition. • Dual-source CT can adequately assess valve leaflet motion and anatomy. • We assessed a comprehensive protocol with three acquisitions for PHV evaluation. • This protocol is associated with good image quality and limited dose. Springer Berlin Heidelberg 2017-12-12 2018 /pmc/articles/PMC5882630/ /pubmed/29234912 http://dx.doi.org/10.1007/s00330-017-5163-7 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Cardiac
Faure, Marguerite E.
Swart, Laurens E.
Dijkshoorn, Marcel L.
Bekkers, Jos A.
van Straten, Marcel
Nieman, Koen
Parizel, Paul M.
Krestin, Gabriel P.
Budde, Ricardo P. J.
Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title_full Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title_fullStr Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title_full_unstemmed Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title_short Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
title_sort advanced ct acquisition protocol with a third-generation dual-source ct scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment
topic Cardiac
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882630/
https://www.ncbi.nlm.nih.gov/pubmed/29234912
http://dx.doi.org/10.1007/s00330-017-5163-7
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