High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT

Veit Sandfort, Mark A. Ahlman, Elizabeth C. Jones, Mariana Selwaness, Marcus Y. Chen, Les R. Folio, David A. Bluemke

Research output: Contribution to journalArticle

Abstract

Background: Chest CT scans are frequently performed in radiology departments but have not previously contained detailed depiction of cardiac structures. Objectives: To evaluate myocardial and coronary visualization on high-pitch non-gated CT of the chest using 3rd generation dual-source computed tomography (CT). Methods: Cardiac anatomy of patients who had 3rd generation, non-gated high pitch contrast enhanced chest CT and who also had prior conventional (low pitch) chest CT as part of a chest abdomen pelvis exam was evaluated. Cardiac image features were scored by reviewers blinded to diagnosis and pitch. Paired analysis was performed. Results: 3862 coronary segments and 2220 cardiac structures were evaluated by two readers in 222 CT scans. Most patients (97.2%) had chest CT for oncologic evaluation. The median pitch was 2.34 (IQR 2.05, 2.65) in high pitch and 0.8 (IQR 0.8, 0.8) in low pitch scans (p <0.001). High pitch CT showed higher image visualization scores for all cardiovascular structures compared with conventional pitch scans (p <0.0001). Coronary arteries were visualized in 9 coronary segments per exam in high pitch scans versus 2 segments for conventional pitch (p <0.0001). Radiation exposure was lower in the high pitch group compared with the conventional pitch group (median CTDIvol 10.83 vs. 12.36 mGy and DLP 790 vs. 827 mGycm respectively, p <0.01 for both) with comparable image noise (p = 0.43). Conclusion: Myocardial structure and coronary arteries are frequently visualized on non-gated 3rd generation chest CT. These results raise the question of whether the heart and coronary arteries should be routinely interpreted on routine chest CT that is otherwise obtained for non-cardiac indications.

Original languageEnglish (US)
JournalJournal of Cardiovascular Computed Tomography
DOIs
StateAccepted/In press - Feb 23 2016
Externally publishedYes

Keywords

  • Cardiac imaging
  • CT
  • Incidental findings

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT'. Together they form a unique fingerprint.

  • Cite this

    Sandfort, V., Ahlman, M. A., Jones, E. C., Selwaness, M., Y. Chen, M., R. Folio, L., & Bluemke, D. A. (Accepted/In press). High pitch third generation dual-source CT: Coronary and cardiac visualization on routine chest CT. Journal of Cardiovascular Computed Tomography. https://doi.org/10.1016/j.jcct.2016.03.007