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Swiss researchers report on diagnostic effectiveness of low dose CT in coronary angiography

Siemens Healthcare UK : 28 July, 2008  (Company News)
Researchers at the University Hospital, Zurich in Switzerland, recently undertook a study into the diagnostic effectiveness of low dose CT in coronary angiography.
The results indicated that Dual Source CT requires a significantly lower dose for heart examinations in comparison to conventional CT. The study also demonstrated that this method can diagnose stenoses with the same high accuracy as an invasive angiography x-ray.

The results of the study were published in the June issue of ‘Heart’, the official journal of the British Cardiovascular Society.

Angiography is a diagnostic procedure used to clarify coronary arterial obstructions. Normally, this examination is conducted using angiography devices in the Catheter laboratory as well as CT scans that expose the patient to a dose of radiation. Researchers at the University Hospital in Zurich wanted to ascertain whether the dose used during CT angiography could be reduced.

During the study, 120 patients with suspected coronary heart disease were scanned with the world's first CT scanner with two X-ray tubes, the Somatom Definition from Siemens Healthcare.

The researchers used the CT with Siemens’ new Adaptive Cardio Sequence application which has been developed for all Somatom Definition Scanners. The application is based on the step-and-shoot method. By calculating the heart’s next diastole, the CT takes an image during only this phase of the cardiac cycle, yielding more useful data for analysis. The combination of Adaptive Cardio Sequence and the Dual Source CT's maximum time resolution of 83ms facilitates this technique in a particularly reliable fashion and permits a further significant reduction in dosage.

“The results show that CT coronary angiography with a dual-source CT in step-and-shoot mode produces images of excellent diagnostic quality in patients with stable heart rates up to 70 bpm. The dosage reduction achieved in comparison to previous CT angiography is also remarkable. In our study, we required an effective dose of 2.5 mSv on average with a deviation of plus/minus 0.8 mSv. In the literature, a normal average effective dose for heart scans of between 9 and 21 mSv is reported,” said Dr Hatem Alkadhi, specialist in radiology at the Institute for Diagnostic Radiology, University Hospital Zurich, Switzerland.

The Adaptive Cardio Sequence supplements the step-and-shoot method with intelligent algorithms which monitor the heart frequency of patients and if necessary, respond to arrhythmia such as additional heart beats. In this case, the recording phase is automatically postponed in order to avoid image errors due to sudden movement. In addition, the recording window can be widened further if required so that the robustness of the CT scan is increased significantly overall.

“The safety of patients has always been the primary focus of developments in CT. At the same time, we consider our highest obligation to be to give doctors the best diagnostic image quality and to support them in making their workflow as efficient as possible. With this outlook and constant further development, Siemens has positioned itself as the market leader in CT technology,” said Dr Sami Atiya, chief executive officer of Computed tomography at Siemens Healthcare.

“The study from Zurich confirms to us that the combination of step-and-shoot and dual-source Computed tomography does significantly reduce the dosage required during heart scans,” stated Russell Lodge, CT product manager at Siemens Healthcare. “This is an exciting clinical development.”
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