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VCT vs HD CCTA ExamVCT vs HD CCTA Exam92% Dose Reduction92% Dose Reduction
James P Earls MD
Fairfax Radiological Consultants, Fairfax VA
Inova Fairfax Hospital, Falls Church VA
History
• 53 yr old male– Had chest pain 2 years ago– Echo, ECG and nuclear stress study all negative
• CCTA 2006– retrospectively gated study on VCT system– showed 90% LAD– Cath confirmed; 5.0 mm bare metal stent placed
• CCTA 2009– Some recurrent CP several months ago– Prospectively gated, ASIR reconstruction on HD system– No evidence of restenosis
Scan Techniques• GE HD CT750
• Scan parameters
– Prospective gating
– 0 msec padding
– 30% Volume ASIR
– High Res mode
– 350 mA, kV 120
• Contrast
– 80 cc Visipaque @ 5.5 cc/sec
• Radiation Dose
– CTDIvol 8.22 mGy
– DLP 115 mGy-cm
– Effective dose 1.61 mSv
• GE VCT
• Scan parameters
– Retrospective gating
– ECG modulation
– 717 mA, kV 120
• Contrast
– 80 cc Visipaque @ 5.5 cc/sec
• Radiation Dose
– CTDIvol 78.6 mGy
– DLP 1419 mGy-cm
– Effective dose 19.8 mSv
92% Dose Reduction!!!
Whole Heart View
VCT Exam 8/2006 HD Exam 2/2009
Tree VR View
VCT Exam 8/2006 HD Exam 2/2009
MIP View
VCT Exam 8/2006 HD Exam 2/2009
LAD
VCT Exam 8/2006 HD Exam 2/2009
LAD
VCT Exam 8/2006 HD Exam 2/2009
Cath Views
Pre-Stent Post-Stent
Cath Views
VCT (8/2006) Cath (8/2006)
Cath Views
HD study (2/2009) Post-Stent (8/2006)
CCTA on the HD