Low-Dose Coronary CT Angiography in Patients with Atrial Fibrillation: Comparison of Image Quality and Radiation Exposure with Two Different Approaches

Saima Mushtaq, Gianluca Pontone, Edoardo Conte, Marco Guglielmo, Elisa Consiglio, Marco Magatelli, Margarida Oliveira, Giuseppe Muscogiuri, Andrea Annoni, Andrea Baggiano, Alberto Formenti, Maria Elisabetta Mancini, Luca Di Odoardo, Eleonora Melotti, Cesare Fiorentini, Antonio L. Bartorelli, Mauro Pepi, Daniele Andreini*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Rationale and Objectives: To evaluate image quality, coronary interpretability and radiation exposure of coronary CT angiography (CCTA)performed in patients with atrial fibrillation (AF)with the latest scanner generation, comparing two different technical approaches. A new scanner that combines a 0.23 mm spatial resolution, a new generation of iterative reconstruction, fast gantry rotation time and the intracycle motion-correction algorithm to improve the temporal resolution was recently introduced in the clinical field. Materials and Methods: We enrolled 105 consecutive patients with chronic AF who performed CCTA with a whole-heart coverage high-definition CT scanner (16-cm z-axis coverage with 256 detector rows, 0.28 s gantry rotation time). Five of them were excluded for impaired renal function. Patients were randomized between a double acquisition protocol (50 patients, group 1)or a single acquisition protocol (50 patients, group 2). The image quality, coronary segment interpretability and effective dose (ED)of CCTA were assessed. Results: The mean HR during the scan was 85.6±21 bpm in group 1 vs. 83.7±23 bpm in Group 2, respectively (p < ns). In group 2, overall image quality was high and comparable with that of group 1 (Likert scale =3.2 ± 1.4 vs. 3.3 ± 1.2, p = ns, in group 1 and 2, respectively). Coronary interpretability was high and similar between the two groups (97.5% and 97.1% in group 1 and 2, p = ns, respectively). Mean ED was significantly higher in group 1 than in group 2 (5.3 ± 1.8 mSv vs. 2.7 ± 0.7 mSv, p < 0.001). Conclusion: The novel whole-heart coverage CT scanner allows to perform CCTA with a single-acquisition protocol with high image quality and low radiation exposure in AF patients.

Original languageEnglish
Pages (from-to)791-797
Number of pages7
JournalAcademic Radiology
Issue number6
Publication statusPublished - Jun 2019
Externally publishedYes


  • Atrial fibrillation
  • Coronary CT angiography
  • Radiation exposure


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