“ In conclusion, preliminary evidence on the assessment of myocardial ischemia and infarction by DECT as an addition to coronary CT angiography suggest that DECT is a promising step toward comprehensive evaluation of coronary heart disease with a single noninvasive modality.”
Dual-Energy CT of the Heart
Vliegenthart R et al.
AJR 2012;199:S54-S63
“ New technology combining dual energy CT with the latest gemstone detectors for spectral imaging (GSI) can be used to synthesize monochromatic images that mimic images as if different monochromatic x-ray sources were used.”
First experience with monochromatic coronary compute tomography angiography from a 64-slice CT scanner with Gemstone Spectral Imaging (GSI)
Fuchs TA et al.
J Cardiovasc Comput Tomogr 7 (2013) 25-31
“ In coronary CTA with low radiation technique (mean radiation dose, 1.8 ± 0.7 mSv), GSI with monochromatic reconstructions (65-75 keV) and ASIR (40-60%) offers significant noise reduction and image quality improvement.”
First experience with monochromatic coronary compute tomography angiography from a 64-slice CT scanner with Gemstone Spectral Imaging (GSI)
Fuchs TA et al.
J Cardiovasc Comput Tomogr 7 (2013) 25-31
“Using 100/140kV increases the dose of radiation but improves the quality of the study of arterial segments and bone subtraction.”
Dual energy CT angiography of the carotid arteries: quality, bone subtraction, and radiation dosage using tube voltage 80/140kV versus 100/140kV
Santos Armentia E et al.
Radiologia 2012 May 15 (epub ahead of print)
Dual Energy CT Scanning: Vascular Applications
1. Vascular CT with automatic bone removal critical
- runoff studies of the lower extremities
-Carotid artery imaging
- Circle of Willis and Base of the Brain
2. Virtual Non-contrast CT for Endovascular Stent Followup
3. Pulmonary embolism with blood flow maps
4. Myocardial perfusion imaging
“Initial reports have suggested that dual energy CTA (DE-CTA) can enhance diagnosis by creating bone-free data sets, which can be visualized in 3D, but a number of limitations of this technique have also been addressed. We sought to describe the performance of DE-CTA of the supraaortic vessels with a novel dual source CT system with special emphasis on image quality and post-processing related artifacts.”
Dual energy CTA of the supraaortic arteries: technical improvements with a novel dual source CT system
Lell MM et al
Eur J Radiol 2010 Nov;76(2)e6-12
“Excellent bone suppression could be achieved, DE imaging with 100 and 140kV lead to improved image quality and vessel integrity in the shoulder region than previously reported.”
Dual energy CTA of the supraaortic arteries: technical improvements with a novel dual source CT system
Lell MM et al
Eur J Radiol 2010 Nov;76(2)e6-12
CCTA: Protocols
Scanner Protocol | High Pitch | Prospective Tiggering | Retrospective Triggering |
Tube current (mAs eff) | 336 | 277 | 320 |
Tube current (kV) | 100 | 100 | 100 |
DLP (mGy cm) | 65.5 ± 8.5 | 244.2 ± 72.1 | 647.3 ± 94.7 |
Effective Radiation dose (mSv) | 1.1 ± 0.14 | 4.15 ± 1.20 | 11.00 ± 1.60 |
Contrast volume (ml) | 65 ± 15 | 80 | 80 |
Flow (ml/sec) | 6 | 5 | 5 |
Scan range (mm) | 141 | 136 | 144 |
Scan time (seconds) | 0.31 | 6.5 | 6.3 |
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
CCTA: High Pitch vs Prospective Triggering
Scanner Protocol | High Pitch | Prospective Tiggering |
Tube current (mAs eff) | 336 | 277 |
Tube current (kV) | 100 | 100 |
DLP (mGy cm) | 65.5 ± 8.5 | 244.2 ± 72.1 |
| Effective Radiation dose (mSv) | 1.1 ± 0.14 | 4.15 ± 1.20 |
Contrast volume (ml) | 65 ± 15 | 80 |
Flow (ml/sec) | 6 | 5 |
Scan range (mm) | 141 | 136 |
| Scan time (seconds) | 0.31 | 6.5 |
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
High Pitch Cardiac CTA Protocol
Scanner Protocol | |
Tube current (mAs eff) | 336 |
Tube current (kV) | 100 |
DLP (mGy cm) | 65.5 ± 8.5 |
Effective Radiation dose (mSv) | 1.1 ± 0.14 |
Contrast volume (ml) | 65 ± 15 |
Flow (ml/sec) | 6 |
Scan range (mm) | 141 |
Scan time (seconds) | 0.31 |
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
“High-pitch protocols lead to good image quality, and optimal contrast enhancement in patients with heart rates below 65 bpm.”
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
“In conclusion, in the current study it could be proven that the recently introduced high-pitch protocols for cardiac CT only need a fraction of radiation dose compared with conventional cardiac CT protocols such as prospectively triggered techniques or spiral acquisitions with retrospective gating.”
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
“ High-pitch scans have the potential to reduce radiation dose up to 61.2% and 89.8% compared with prospectively triggered and retrospectively gated scans. High pitch protocols lead to excellent image quality when used in patients with stable heart rates below 65 bpm.”
Feasibility and Radiation Dose of High-Pitch Acquisition Protocols in Patients Undergoing Dual-Source Cardiac CT
Sommer WH et al.
AJR 2010; 195:1306-1312
