Ultra-fast, low dose high-pitch (FLASH) versus prospectively-gated coronary computed tomography angiography: Comparison of image quality and patient radiation exposure

摘要

BackgroundCoronary computed tomography angiography (CCTA) is increasingly being used for the evaluation of coronary artery disease; however, radiation exposure remains a major limitation of its use.ObjectiveTo compare image quality and radiation exposure in two groups of patients undergoing CCTA using a 256-slice dual-source helical computed tomography scanner with high-pitch (FLASH) or prospective [step-and-shoot (SAS)] gating protocols.MethodsA prospective, single-center study was performed in our cardiac center. In total, 162 patients underwent CCTA with either FLASH or SAS scanning protocols. Subjective image quality was graded on the basis of a four-point grading system (1, non-diagnostic; 2, adequate; 3, good; 4, excellent). Objective image quality was assessed using image signal, noise, and signal-to-noise ratio (SNR). The effective radiation dose was also estimated.ResultsThe clinical and demographic characteristics of the patients in both groups were similar. The median age of the patients in both groups was 48.43?years, and males accounted for 63% and 68.7% of the FLASH and SAS groups, respectively. We found that the subjective image quality obtained with the FLASH protocol was superior to that obtained with the SAS protocol (3.35?±?0.6?mSv vs. 2.82?±?0.61?mSv;p??0.001) and (21.6?±?8.7?mSv vs. 16.6?±?7.7?mSv;p?