Image Quality and Radiation Exposure With Prospectively ECG-Triggered Axial Scanning for Coronary CT Angiography The Multicenter, Multivendor, Randomized PROTECTION-III Study
Image Quality and Radiation Exposure With Prospectively ECG-Triggered Axial Scanning for Coronary CT Angiography The Multicenter, Multivendor, Randomized PROTECTION-III Study
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DOI：
10.1016/j.jcmg.2011.12.017
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发表时间：
2012-05-01
影响因子：
14
通讯作者：
Achenbach, Stephan
中科院分区：
文献类型：
--
作者：
Hausleiter, Jorg;Meyer, Tanja S.;Achenbach, Stephan
本研究的目的是评价图像质量和辐射剂量使用前瞻性心电图（ECG）触发的轴向扫描协议相比，标准的回顾性心电门控螺旋扫描冠状动脉计算机断层扫描angiography.BACKGROUND的关注已经提出了关于辐射暴露在冠状动脉计算机断层扫描angiography.BACKGROUND。虽然使用前瞻性心电图触发的轴向扫描协议可以有效地降低辐射剂量相比，螺旋扫描，它是未知的图像质量是否保持在临床setting.METHODS在一个前瞻性的，多中心的，多供应商的试验，400例患者低和稳定的心率被随机分配到轴向或螺旋冠状动脉计算机断层扫描血管造影扫描协议。主要终点是证明轴向扫描方案的图像质量非劣效性，采用4分量表进行评估（1 =非诊断性，4 =图像质量极佳）。次要终点包括30天随访期间的辐射剂量和下游检测率。结果轴向扫描方案扫描患者的图像质量（得分3.36 +/- 0.59）并不劣于螺旋扫描方案（3.37 +/- 0.59）（p为非劣效性
OBJECTIVES The purpose of this study was to evaluate image quality and radiation dose using a prospectively electrocardiogram (ECG)-triggered axial scan protocol compared with standard retrospective ECG-gated helical scanning for coronary computed tomography angiography.BACKGROUND Concerns have been raised regarding radiation exposure during coronary computed tomography angiography. Although the use of prospectively ECG-triggered axial scan protocols may effectively lower radiation dose compared with helical scanning, it is unknown whether image quality is maintained in a clinical setting.METHODS In a prospective, multicenter, multivendor trial, 400 patients with low and stable heart rates were randomized to either an axial or a helical coronary computed tomography angiography scan protocol. The primary endpoint was to demonstrate noninferiority in image quality with the axial scan protocol, which was assessed on a 4-point scale (1 = nondiagnostic, 4 = excellent image quality). Secondary endpoints included radiation dose and the rate of downstream testing during 30-day follow-up.RESULTS Image quality in patients scanned with the axial scan protocol (score 3.36 +/- 0.59) was not inferior compared with helical scan protocols (3.37 +/- 0.59) (p for noninferiority