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Prospective ECG-gated High-Pitch Photon-Counting CT Angiography: Evaluation of measurement accuracy for aortic annulus sizing in TAVR planning.
Yang, Y; Richter, R; Halfmann, M C; Graafen, D; Hell, M; Vecsey-Nagy, M; Laux, G; Kavermann, L; Jorg, T; Geyer, M; Varga-Szemes, A; Emrich, T.
Afiliación
  • Yang Y; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Richter R; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Halfmann MC; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Graafen D; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Hell M; Department of Cardiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Vecsey-Nagy M; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States; Heart and Vascular Center, Semmelweis University, 68. Varosmajor Street, Budapest 1122, Hungary.
  • Laux G; Department of Cardiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Kavermann L; Department of Cardiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Jorg T; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Geyer M; Department of Cardiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.
  • Varga-Szemes A; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States.
  • Emrich T; Department of Diagnostic and Interventional Radiology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; Department of Radiology and Radiological Science, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States. Electronic address: Tilman.
Eur J Radiol ; 178: 111604, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38996738
ABSTRACT

PURPOSE:

In planning transcatheter aortic valve replacement (TAVR), retrospective cardiac spiral-CT is recommended to measure aortic annulus with subsequent CT-angiography (CTA) to evaluate access routes. Photon-counting detector (PCD)-CT enables to assess the aortic annulus in desired cardiac phases, using prospective ECG-gated high-pitch CTA. The aim of this study was to evaluate the measurement accuracy of aortic annulus using prospective ECG-gated high-pitch CTA against retrospective spiral-CT reference.

METHOD:

Thirty patients underwent cardiac spiral-CT and prospective ECG-gated (30% R-R on aortic valve level) high-pitch CTA. Using propensity score matching, another 30 patients were identified whose CTA was performed using high-pitch mode without ECG-synchronization. Two investigators measured annular diameter, perimeter, and area on cardiac spiral-CT and high-pitch CTA.

RESULTS:

The aortic valve was imaged in systole in 90 % of prospective ECG-gated CTA cases but only 50 % of non-ECG-gated CTA cases (p = 0.002). There was a strong correlation (r ≥ 0.94) without significant differences (p ≥ 0.09) between cardiac spiral-CT and prospective ECG-gated high-pitch CTA for all annulus measurements. In contrast, significant differences were found in annular short-axis diameter and area between cardiac spiral-CT and non-ECG-gated high-pitch CTA (p ≤ 0.03). Furthermore, prospective ECG-gated high-pitch CTA showed significantly reduced radiation exposure compared with cardiac spiral-CT (CTDI 4.52 vs. 24.10 mGy; p < 0.001).

CONCLUSION:

PCD-CT-based prospective ECG-gated high-pitch scans with targeted systolic acquisition at the level of the aortic valve can simultaneously visualize TAVR access routes and accurately measure systolic annulus size. This approach could aid in optimizing protocols to achieve lower radiation doses in the growing population of younger, low-risk TAVR patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Técnicas de Imagen Sincronizada Cardíacas / Reemplazo de la Válvula Aórtica Transcatéter / Angiografía por Tomografía Computarizada Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Eur J Radiol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Técnicas de Imagen Sincronizada Cardíacas / Reemplazo de la Válvula Aórtica Transcatéter / Angiografía por Tomografía Computarizada Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Eur J Radiol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Irlanda