Congress:
EuroSafe Imaging 2017
Keywords:
Diagnostic procedure, CT-Angiography, Cardiac, Action 5 - Performance indicators for radiation protection management, Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Clinical audit tool for imaging, Action 9 - Development of criteria for safe imaging procedures, Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical audit, Radiation safety, Dosimetric comparison, Quality assurance
Authors:
J. Hakumäki, J. Vienonen, M. Hedman, P. Saari, H. Matikka, M. Husso, R. Vanninen
DOI:
10.1594/esi2017/ESI-0044
Description of activity and work performed
Study protocol
This self-evaluation study assessed all consecutive CCTA procedures during a one-year period (1.2.2015-31.1.2016) at Kuopio University Hospital in Finland.
A Siemens Somatom Definition Flash scanner was used for imaging.
The research material consisted of 210 patients,
two-thirds of which were women and had an average+SD age of 53+10 years and weight of 79+17 kg.
Results
The status of coronary artery disease was successfully identified with CCTA in 98.6% (n=207) of patients.
Altogether 25.6% of the patients (n=54) had signs of atherosclerosis in coronary arteries but without significant stenosis,
while 10.1% of the patients (n=21) were found to have stenoses in coronary arteries.
Additional imaging after CCTA was needed in 10.1% (n=21) of the cases.
71,4% (n=15) of these being scheduled for invasive catheter angiography.
Extracardiac findings were seen in 16,7% (n=35) of all patients.
The average patient-specific radiation dose of CCTA was 3 mSv.
Of the various CCTA protocols,
the so called Flash-protocol3 (a prospective,
high pitch scan during one heart beat) had the best diagnostic success rate (Figure 1) concomitant with the lowest average dose per patient (2mSv),
see Table 1.
The correlations between known coronary artery disease risk factors and rate of arteriosclerosis in coronary arteries were as follows: positive family history of coronary heart disease (p = 0.022),
hypertension (p = 0.012),
hypercholesterolemia (p <0.001) and smoking (p = 0.012).