European Heart Journal Advance Access published online on November 5, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp470
Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition
1 Department of Cardiology, University of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany
2 Institute of Radiology, University of Erlangen, Germany
Received 29 May 2009; revised 1 September 2009; accepted 21 September 2009 * Corresponding author. Tel: +49 9131 8535000, Fax: +49 9131 8535303, Email: stephan.achenbach{at}uk-erlangen.de
Aims: We evaluated the feasibility and image quality of a new scan mode for coronary computed tomography angiography (CTA) with an effective dose of less than 1 mSv.
Methods and results: In 50 consecutive patients (body weight 
100 kg, sinus rhythm 60 b.p.m. after pre-medication, coronary CTA was performed using a dual-source CT system with 2 x 128 x 0.6 mm collimation, 0.28 s rotation time, a pitch of 3.2 or 3.4, 100 kV tube voltage and current of 320 mA s. Data acquisition was prospectively triggered at 60% of the R–R interval and completed within one cardiac cycle. Image quality was evaluated using a four-point scale (1 = absence of any artefacts to 4 = uninterpretable). In all 50 patients, imaging was successful. Mean duration of data acquisition was 258 ± 20 ms. Mean dose-length product was 62 ± 5 mGy cm, the effective dose was 0.87 ± 0.07 mSv (0.78–0.99 mSv). Of the 742 coronary artery segments, 94% had an image quality score of 1, 5.0% a score of 2, 0.9% a score of 3, and 4 segments (0.5%) were ‘uninterpretable’.
Conclusion: In non-obese patients with a low and stable heart rate, prospectively ECG-triggered high-pitch spiral coronary CTA provides excellent image quality at a consistent dose below 1.0 mSv.
Key Words: Computed tomography • Coronary CT angiography • Dual-source CT • Radiation exposure