Cardiac computed tomography previous to atrial fibrillation ablation - effects of technological improvements and protocol optimization.

Autor:	Marques H; Unidade de Imagem Cardiovascular por TC e RM (Unica), Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal; Serviço de Radiologia, Hospital de Santa Marta, CHLC, Lisboa, Portugal; Nova Medical School, Lisboa, Portugal., de Araújo Gonçalves P; Unidade de Imagem Cardiovascular por TC e RM (Unica), Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal; Nova Medical School, Lisboa, Portugal; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal. Electronic address: paraujogoncalves@yahoo.co.uk., Ferreira AM; Unidade de Imagem Cardiovascular por TC e RM (Unica), Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal., Cruz R; Serviço de Imagiologia, Hospital Beatriz Ângelo, Loures, Portugal., Lopes J; Serviço de Radiologia, Hospital de Santa Marta, CHLC, Lisboa, Portugal., Santos RD; Unidade de Imagem Cardiovascular por TC e RM (Unica), Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal; Serviço de Radiologia, Hospital de Santa Marta, CHLC, Lisboa, Portugal., Radu L; Unidade de Imagem Cardiovascular por TC e RM (Unica), Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal., Costa F; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal., Mesquita J; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal., Carmo P; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal., Cavaco D; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal., Parreira L; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal., Pisco J; Nova Medical School, Lisboa, Portugal., Goyri O'Neill J; Nova Medical School, Lisboa, Portugal., Adragão P; Serviço de Cardiologia, Hospital de Santa Cruz, CHLO, Lisboa, Portugal; Centro Cardiovascular, Hospital da Luz Lisboa, Portugal.
Jazyk:	English; Portuguese
Zdroj:	Revista portuguesa de cardiologia [Rev Port Cardiol (Engl Ed)] 2018 Nov; Vol. 37 (11), pp. 873-883. Date of Electronic Publication: 2018 Nov 19.
DOI:	10.1016/j.repc.2018.03.011
Abstrakt:	Background: Cardiac computed tomography (CT) can provide a precise tridimentional anatomic map and exclude intra-cardiac thrombus. We aimed to access the impact of CT protocol optimization and technological evolution on the contrast and radiation dose as well as on image quality previous to atrial fibrillation (AF) ablation. Methods: From a prospective registry of consecutive patients who underwent cardiac CT in a single center, we selected 270 patients in whom the CT was done for evaluation prior to AF ablation and they were distributed in 3 groups: Group1: the first 150 patients included; Group2: the last 60 patients performed with the same CT scanner; Group3: the first 60 exams performed with the new CT scanner. Quality of the protocol was access based on radiation dose, contrast volume used, the use of a second (delayed) acquisition, and on quantitative image quality analisis (signal to noise and contrast to noise ratios; density homogeneity racio between LA and LAA). Results: We found a significant radiation dose as well as contrast dose reduction between the first and last subgroups (G1: 5,6mSv and 100ml; G2: 1,3mSv and 90ml; G3: 0,6mSv and 65ml). Even though group 3 had less radiation and contrast used it still had better quantitative image quality (signal/noise of 13,5; contrast/noise 14,8; density homogeneity racio of 0,92). Conclusion: Protocol optimization and technology both contributed to significant lower radiation dose and contrast volume used on cardiac CTs prior to AF ablation, without compromising image quality. (Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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