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- Title
Low contrast medium-volume third-generation dual-source computed tomography angiography for transcatheter aortic valve replacement planning.
- Authors
Felmly, Lloyd; Cecco, Carlo; Schoepf, U.; Varga-Szemes, Akos; Mangold, Stefanie; McQuiston, Andrew; Litwin, Sheldon; Bayer, Richard; Vogl, Thomas; Wichmann, Julian; Felmly, Lloyd M; De Cecco, Carlo N; Schoepf, U Joseph; McQuiston, Andrew D; Litwin, Sheldon E; Bayer, Richard R 2nd; Vogl, Thomas J; Wichmann, Julian L
- Abstract
<bold>Purpose: </bold>To investigate feasibility, image quality and safety of low-tube-voltage, low-contrast-volume comprehensive cardiac and aortoiliac CT angiography (CTA) for planning transcatheter aortic valve replacement (TAVR).<bold>Materials and Methods: </bold>Forty consecutive TAVR candidates prospectively underwent combined CTA of the aortic root and vascular access route (270 mgI/ml iodixanol). Patients were assigned to group A (second-generation dual-source CT [DSCT], 100 kV, 60 ml contrast, 4.0 ml/s flow rate) or group B (third-generation DSCT, 70 kV, 40 ml contrast, 2.5 ml/s flow rate). Vascular attenuation, noise, signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were compared. Subjective image quality was assessed by two observers. Estimated glomerular filtration (eGFR) at CTA and follow-up were measured.<bold>Results: </bold>Besides a higher body-mass-index in group B (24.8±3.8 kg/m2 vs. 28.1±5.4 kg/m2, P=0.0339), patient characteristics between groups were similar (P≥0.0922). Aortoiliac SNR (P=0.0003) was higher in group B. Cardiac SNR (P=0.0003) and CNR (P=0.0181) were higher in group A. Subjective image quality was similar (P≥0.213) except for aortoiliac image noise (4.42 vs. 4.12, P=0.0374). TAVR-planning measurements were successfully obtained in all patients. There were no significant changes in eGFR among and between groups during follow-up (P≥0.302).<bold>Conclusion: </bold>TAVR candidates can be safely and effectively evaluated by a comprehensive CTA protocol with low contrast volume using low-tube-voltage acquisition.<bold>Key Points: </bold>• Third-generation dual-source CT facilitates low-tube-voltage acquisition. • TAVR planning can be performed with reduced contrast volume and radiation dose. • TAVR-planning CT did not result in changes in creatinine levels at follow-up. • TAVR candidates can be safely evaluated by comprehensive low-tube-voltage CT angiography.
- Subjects
ANGIOGRAPHY; AORTIC stenosis; AORTIC stenosis treatment; CHEMOEMBOLIZATION; CREATININE; DIAGNOSIS
- Publication
European Radiology, 2017, Vol 27, Issue 5, p1944
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4537-6