EKG-triggered CT data acquisition to reduce variability in coronary arterial calcium score |
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Authors: | Lu Bin Zhuang Nan Mao Song-Shou Child Janis Carson Sivi Bakhsheshi Hamid Budoff Matthew J |
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Institution: | Department of Radiology, FuWai Cardiovascular Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China. |
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Abstract: | PURPOSE: To test the hypothesis that computed tomographic (CT) scanning during optimal electrocardiographic (EKG) triggering can minimize image motion artifact and reduce interexamination variation of coronary arterial calcification (CAC) score at electron-beam CT. MATERIALS AND METHODS: Two hundred patients underwent electron-beam CT once and again 5 minutes later to evaluate interexamination variability of CAC score. Group 1 (104 patients) underwent scanning with use of an optimal EKG-triggering protocol (EKG triggering performed individually at the time of least coronary arterial motion during the cardiac cycle); group 2 (96 patients) underwent scanning with use of conventional 80% R-R interval triggering (the most common protocol with the electron-beam CT scanner). Interexamination, intraobserver, and interobserver variations of CAC measurements were compared between groups by using unpaired t tests for both Agatston and volumetric scores (in square millimeters). RESULTS: Coronary arterial motion artifacts were found in 26% (27 of 104) versus 80% (77 of 96) of patients in groups 1 and 2, respectively (P <.0001). Intraobserver, interobserver, and interexamination variabilities in volumetric score were derived, with values of 1.2%, 9.2%, and 15.9% in group 1 and 2.1%, 11.3%, and 25.9% in group 2, respectively. Interexamination variabilities in both Agatston and volumetric score were significantly reduced with individualized EKG triggering, as compared with conventional triggering (P <.05), but intra- and interobserver variabilities were not (P >.05). CONCLUSION: Optimal EKG triggering improves the reproducibility of CAC measurement by reducing coronary arterial motion artifacts. |
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