Purpose
To investigate the value of coronary computed tomography angiography (CCTA) in the obese population.
Primary,
we evaluate image quality and radiation dose in different classes of obesity in CCTA using a retrospective scan protocol.
Secondly,
we compare radiation dose used in retrospective and prospective acquisition modes.
Methods and Materials
Patients who were referred for CCTA between June 2005 and September 2015 and who had a calciumscore = 0 (n = 4075) were included in this retrospective analysis (Fig. 2).
Patients were subdivided in five weight classes according to BMI (class 0: BMI 18-24; 1: BMI 25-29; 2: 30-34; 3: 35-39; 4: BMI>40) and according to scan protocol (retrospective CCTA: n = 2919,
prospective CCTA: n = 1156).
In patients with a retrospective CCTA the interpretability of the coronary arteries per patient and per segment...
Results
The statistical analysis of the study population showes a uniform distribution of patients in the different weight classes (Fig. 4).The coronary arteries are subdivided in 17 segments according to the AHA.There is a good overall interpretability of the coronary segments (Fig. 5) in all weight classes (class 0: 92%,
class 1: 96%,
class 2: 96%,
class 3: 92% and class 4: 94.8%).
The results show no decrease in image quality of the coronary arteries with increasing weight.
However,
this is at the expense of higher...
Conclusion
CCTA is feasible in all subgroups of obesity,
but this is at the expense of higher radiation dose in the higher weight classes in order to compensate the decreased signal-noise ratio and the increased scattering.
References
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Step-and-shoot prospectively ECG-gated versus retrospectively E CG-gated with tube current modulation coronary CT angiography using the 128-slice MDCT: comparison of image quality and radiation dose.
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SCCT guidelines for the interpretation and reporting of coronary computed tomographic...
