The effect of heart rate on exposure window and best phase for stress perfusion computed tomography: Lessons from the CORE320 study

Chloe Steveson, Joanne D. Schuijf, Andrea L. Vavere, Richard T. Mather, Teresa Caton, Vishal Mehra, Aisha Betoko, Christopher Cox, C. Joao A.C. Lima, Richard T. George

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives The aim of this study is to evaluate the effect of heart rate on exposure window, best phase, and image quality for stress computed tomography perfusion (CTP) in the CORE320 study. Methods The CTP data sets were analyzed to determine the best phase for perfusion analysis. A predefined exposure window covering 75% to 95% of the R-R cycle was used. Results Of the 368 patients included in the analysis, 93% received oral β blockade before the rest scan. The median heart rate during the stress acquisition was 69 bpm (interquartile range [IQR], 60-77). The median best phase was 81% (IQR, 76-90), and length of exposure window was 22% (IQR, 19-24). The best phase was significantly later in the cardiac cycle with higher heart rates (P < 0.001), and higher heart rates resulted in a small, but higher number of poor quality scans (6%, P < 0.001). The median effective dose of the stress scan was 5.3 mSv (IQR, 3.8-6.1). Conclusions Stress myocardial CTP imaging can be performed using prospective electrocardiography triggering, an exposure window of 75% to 95%, and β-blockade resulting in good or excellent image quality in the majority (80%) of patients while maintaining a low effective radiation dose.

Original languageEnglish (US)
Pages (from-to)242-248
Number of pages7
JournalJournal of computer assisted tomography
Volume41
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

  • computed tomography
  • exposure window
  • heart rate
  • image quality
  • myocardial perfusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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