Program Information
A Low-Dose Prospective First-Pass Analysis Dynamic CT Perfusion Technique for Accurate Myocardial Perfusion Measurement
L Hubbard*, S Malkasian , B Dertli , J Kwon , P Abbona , S Molloi , University of California, Irvine, CA
Presentations
SU-K-201-1 (Sunday, July 30, 2017) 4:00 PM - 6:00 PM Room: 201
Purpose: To evaluate the accuracy of a low-dose prospective first-pass-analysis (FPA) dynamic computed tomography perfusion (CTP) technique for accurate myocardial perfusion measurement.
Methods: The accuracy of a low-dose prospective FPA dynamic CTP technique was evaluated via direct comparison to a previously validated, retrospective FPA dynamic CTP technique in a swine animal model (50 - 90 kg). Contrast was injected peripherally (370 mg/mL iodine, 1 mL/kg, 5 mL/s), followed by a saline chaser (0.5 mL/kg, 5 mL/s), and whole-heart volume scans were dynamically acquired at baseline and hyperemia using a 320-slice CT scanner at 100 kVp and 70 mAs. Only two optimally timed volume scans were acquired for low-dose prospective FPA dynamic CTP through the use of dynamic bolus tracking, while a total of 20 consecutive volume scans were acquired for retrospective FPA dynamic CTP. The result of low-dose prospective FPA dynamic CTP was then compared quantitatively to the result of retrospective FPA dynamic CTP through linear regression. The effective dose of low-dose FPA dynamic CTP was also estimated using the dose-length product per acquisition and a standard adult chest conversion factor of 0.015.
Results: The result of low-dose prospective FPA dynamic CTP (P_PRO) was in good agreement with the result of retrospective FPA dynamic CTP (P_RETRO) at baseline and hyperemia (P_PRO = 0.95 P_RETRO - 0.06, R² = 0.98, 95% CI [0.844, 1.062], p < 0.001, SEE = 0.12 mL/min/g). The effective radiation dose of low-dose prospective FPA dynamic CTP was estimated to be 2.02 mSv at 100 kV and 70 mAs; much lower than the ~10 mSv effective radiation dose of current dynamic CTP techniques.
Conclusion: Low-dose prospective FPA dynamic CTP yields accurate myocardial perfusion data at baseline and hyperemia, with a four-fold reduction in effective dose, as compared to current dynamic CTP techniques.
Funding Support, Disclosures, and Conflict of Interest: Grant funding from Toshiba America Medical Systems.
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