A novel ultrafast-low-dose computed tomography protocol allows concomitant coronary artery evaluation and lung cancer screening
Open Access
- 8 May 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Cardiovascular Disorders
- Vol. 18 (1), 90
- https://doi.org/10.1186/s12872-018-0830-4
Abstract
Background: Cardiac computed tomography (CT) is often performed in patients who are at high risk for lung cancer in whom screening is currently recommended. We tested diagnostic ability and radiation exposure of a novel ultra-low-dose CT protocol that allows concomitant coronary artery evaluation and lung screening. Methods: We studied 30 current or former heavy smoker subjects with suspected or known coronary artery disease who underwent CT assessment of both coronary arteries and thoracic area (Revolution CT, General Electric). A new ultrafast-low-dose single protocol was used for ECG-gated helical acquisition of the heart and the whole chest. A single IV iodine bolus (70-90 ml) was used. All patients with CT evidence of coronary stenosis underwent also invasive coronary angiography. Results: All the coronary segments were assessable in 28/30 (93%) patients. Only 8 coronary segments were not assessable in 2 patients due to motion artefacts (assessability: 98%; 477/485 segments). In the assessable segments, 20/21 significant stenoses (> 70% reduction of vessel diameter) were correctly diagnosed. Pulmonary nodules were detected in 5 patients, thus requiring to schedule follow-up surveillance CT thorax. Effective dose was 1.3 +/- 0.9 mSv (range: 0.8-3.2 mSv). Noteworthy, no contrast or radiation dose increment was required with the new protocol as compared to conventional coronary CT protocol. Conclusions: The novel ultrafast-low-dose CT protocol allows lung cancer screening at time of coronary artery evaluation. The new approach might enhance the cost-effectiveness of coronary CT in heavy smokers with suspected or known coronary artery disease.Keywords
This publication has 24 references indexed in Scilit:
- 320-row computed tomography coronary angiography vs. conventional coronary angiography in patients with suspected coronary artery disease: A systematic review and meta-analysisInternational Journal of Cardiology, 2013
- Lung Cancer: Epidemiology, Etiology, and PreventionClinics in Chest Medicine, 2011
- A systematic review on diagnostic accuracy of CT-based detection of significant coronary artery diseaseEuropean Journal of Radiology, 2008
- Ultra-Low-Dose MDCT of the Chest: Influence on Automated Lung Nodule DetectionKorean Journal of Radiology, 2008
- The pathophysiology of cigarette smoking and cardiovascular disease: An updateJournal of the American College of Cardiology, 2004
- Multislice CT Coronary Angiography: Evaluation of an Automatic Vessel Detection ToolRöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2004
- Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD InitiativeAnnals of Internal Medicine, 2003
- Early effects of tissue-type plasminogen activator added to conventional therapy on the culprit coronary lesion in patients presenting with ischemic cardiac pain at rest. Results of the Thrombolysis in Myocardial Ischemia (TIMI IIIA) Trial.Circulation, 1993
- Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms.Circulation, 1985
- A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart AssociationCirculation, 1975