Key result
An ultra-low radiation dose CT protocol for TAVI planning provided 89.0% diagnostic accuracy for CAD, and higher AVCS and CACS were significantly associated with 90-day MACE complications.
Why the study?
To investigate the feasibility of an ultra-low radiation dose and contrast volume third-generation dual-source CT protocol for TAVI planning, CAD assessment, and calcium scoring, and evaluate their relationship with TAVI outcomes.
Does an ultra-low radiation dose and contrast volume CT protocol provide feasible TAVI planning and correlate with clinical outcomes in patients undergoing TAVI?
Observational (n=203)
Does an ultra-low radiation dose and contrast volume CT protocol provide feasible TAVI planning and correlate with clinical outcomes in patients undergoing TAVI?
An ultra-low radiation dose and contrast volume CT protocol using third-generation dual-source CT is feasible for TAVI planning and CAD assessment, with calcium scores correlating with short-term clinical outcomes.
Ultra-low-dose TAVI CT protocol is feasible with 89% CAD accuracy at 2.8 mSv; leaves open whether AVCS/CACS predict outcomes pending prospective validation.
Objective: To investigate the feasibility of an ultra-low radiation dose and contrast volume protocol using third-generation dual-source (DS) CT for transcatheter aortic valve implantation (TAVI) planning with coronary artery disease (CAD) assessment, coronary artery calcium score (CACS) and aortic valve calcium score (AVCS) quantification and to evaluate their relationship with TAVI outcome. Methods: In this retrospective study were selected 203 patients (131 males, 79.4 ± 5.4 years) underwent to TAVI and at 30- and 90-day follow-up. All patients had performed a third-generation 2 × 192-slices DSCT. The CT protocol included a non-contrast and a contrast high-pitch aortic acquisition for TAVI planning and CAD assessment. Semi-qualitative and quantitative image analysis were performed; the performance in CAD assessment was compared with ICA; the relationship between AVCS and CACS and paravalvular aortic regurgitation (PAR) and major cardiovascular events (MACEs) were evaluated. Mean radiation dose were calculated. Non-parametric tests were used. Results: Semi-qualitative image analysis was good. Contrast enhancement >500 Hounsfield unit (HU) and contrast-to-noise ratio <20 were obtained in all segments. The diagnostic accuracy in CAD was 89.0%. AVCS was significantly higher in patients with 30-day severe PAR. AVCS and CACS were higher in patients with 90-day MACE complications, respectively, 1904.5 ± 621.3 HU (p < 0.0001) and 769.2 ± 365.5 HU (p < 0.0230). Mean radiation dose was 2.8 ± 0.3 mSv. Conclusion: A TAVI planning ultra-low radiation dose and contrast volume protocol using third-generation DSCT provides highly diagnostic images with CAD assessment, AVCS and CACS quantification and these latter were related with TAVI outcomes. Advances in knowledge: The proposed protocol using third-generation 2 × 192-slices DSCT allows with an ultra-low radiation dose and contrast volume the TAVI planning and the coronary artery assessment.
No takes yet. Share an insight, caveat, or question.
Fogante et al. (2023) conducted an observational in Transcatheter aortic valve implantation (TAVI) planning (n=203). Ultra-low radiation dose and contrast volume CT protocol vs. Invasive coronary angiography (for CAD assessment) was evaluated on Diagnostic accuracy for CAD and relationship of AVCS/CACS with PAR and MACEs. An ultra-low radiation dose CT protocol for TAVI planning provided 89.0% diagnostic accuracy for CAD, and higher AVCS and CACS were significantly associated with 90-day MACE complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: