Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy

Purpose. To perform a systematic review of the radiation dose and diagnostic accuracy of prospective versus retrospective ECG-gated multislice CT coronary angiography. Materials and methods. A search of Pubmed/Medline and Sciencedirect databases for English literature was performed to identify studi...

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Main Authors: Sun, Zhonghua, Ng, Kwan-Hoong
Format: Journal Article
Published: Elsevier Ireland Ltd 2011
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Online Access:http://hdl.handle.net/20.500.11937/41029
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author Sun, Zhonghua
Ng, Kwan-Hoong
author_facet Sun, Zhonghua
Ng, Kwan-Hoong
author_sort Sun, Zhonghua
building Curtin Institutional Repository
collection Online Access
description Purpose. To perform a systematic review of the radiation dose and diagnostic accuracy of prospective versus retrospective ECG-gated multislice CT coronary angiography. Materials and methods. A search of Pubmed/Medline and Sciencedirect databases for English literature was performed to identify studies comparing prospective and retrospective ECG-gated multislice CT angiography in the diagnosis of coronary artery disease. Effective dose, dose length product, image quality and diagnostic value were compared between two groups of studies.Results. 22 studies were included for analysis. The mean effective dose of prospective ECG-gated scans was 4.5 mSv (95% CI: 3.6, 5.3 mSv), which is significantly lower than that of retrospective scans, which is 13.8 mSv (95% CI: 11.5, 16.0 mSv) (p < 0.001). The mean dose length product was 225 mGy cm (95% CI: 188, 262 mGy cm) and 822 mGy cm (95% CI: 630, 1013 mGy cm) for the prospective and retrospective ECG-gated scans, respectively, indicating a statistically significant difference between these two protocols (p < 0.0001). The mean sensitivity and specificity of multislice CT angiography in the diagnosis of coronary artery disease was 97.7% (95% CI: 93.7%, 100%) and 92.1% (95% CI: 87.2%, 97%) for prospective ECG-gated scans; 95.2% (95% CI: 91%, 99.5%) and 94.4% (95% CI: 88.5%, 100%) for retrospective ECG-gated scans, respectively, with no significant difference for sensitivity but significant difference for specificity (p = 0.047). Conclusion. Multislice CT coronary angiography with prospective ECG-gating leads to a significant reduction of radiation dose when compared to that of retrospective ECG-gating, while offering comparable image quality and diagnostic value.
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spelling curtin-20.500.11937-410292019-02-19T04:26:47Z Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy Sun, Zhonghua Ng, Kwan-Hoong Coronary artery disease Radiation dose Prospective ECG-gating CT angiography Image quality Purpose. To perform a systematic review of the radiation dose and diagnostic accuracy of prospective versus retrospective ECG-gated multislice CT coronary angiography. Materials and methods. A search of Pubmed/Medline and Sciencedirect databases for English literature was performed to identify studies comparing prospective and retrospective ECG-gated multislice CT angiography in the diagnosis of coronary artery disease. Effective dose, dose length product, image quality and diagnostic value were compared between two groups of studies.Results. 22 studies were included for analysis. The mean effective dose of prospective ECG-gated scans was 4.5 mSv (95% CI: 3.6, 5.3 mSv), which is significantly lower than that of retrospective scans, which is 13.8 mSv (95% CI: 11.5, 16.0 mSv) (p < 0.001). The mean dose length product was 225 mGy cm (95% CI: 188, 262 mGy cm) and 822 mGy cm (95% CI: 630, 1013 mGy cm) for the prospective and retrospective ECG-gated scans, respectively, indicating a statistically significant difference between these two protocols (p < 0.0001). The mean sensitivity and specificity of multislice CT angiography in the diagnosis of coronary artery disease was 97.7% (95% CI: 93.7%, 100%) and 92.1% (95% CI: 87.2%, 97%) for prospective ECG-gated scans; 95.2% (95% CI: 91%, 99.5%) and 94.4% (95% CI: 88.5%, 100%) for retrospective ECG-gated scans, respectively, with no significant difference for sensitivity but significant difference for specificity (p = 0.047). Conclusion. Multislice CT coronary angiography with prospective ECG-gating leads to a significant reduction of radiation dose when compared to that of retrospective ECG-gating, while offering comparable image quality and diagnostic value. 2011 Journal Article http://hdl.handle.net/20.500.11937/41029 10.1016/j.ejrad.2011.01.070 Elsevier Ireland Ltd fulltext
spellingShingle Coronary artery disease
Radiation dose
Prospective ECG-gating
CT angiography
Image quality
Sun, Zhonghua
Ng, Kwan-Hoong
Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title_full Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title_fullStr Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title_full_unstemmed Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title_short Prospective versus retrospective ECG-gated multislice CT coronary angiography: A systematic review of radiation dose and diagnostic accuracy
title_sort prospective versus retrospective ecg-gated multislice ct coronary angiography: a systematic review of radiation dose and diagnostic accuracy
topic Coronary artery disease
Radiation dose
Prospective ECG-gating
CT angiography
Image quality
url http://hdl.handle.net/20.500.11937/41029