New trends in Cardiovascular Imaging
Hatem Alkadhi, MD, MPH, EBCR
Institute of Diagnostic and Interventional Radiology
synopsis
Automated tube voltage selection
- CT Angiography
Cardiac CT
- Turbo flash mode
CT Angiography
- low contrast media volume examinations
Cardiovascular CT: tomorrow ?
earlier study – CTA of the aorta
fix 120 kVp vs automated tube voltage selection
• SOMATOM Flash (80/100/120/140 kVp)
-18%
Götti et al., AJR 2012; 199:W380-5
Automated tube voltage selection
Study with SOMATOM Force on 40 patients
follow-up CTA of the aorta
Previous CT in the same patients with SOMATOM Flash
identical CTA-protocol
• CAREkV, 100 ref kVp, 90 ref mAs
identical contrast media protocol
• 80ml Ultravist® 300: 25 ml @ 5 ml/s and 45 ml @ 2.5 ml/s
Automated tube voltage selection
FLASH FORCE
FLASH FORCE
-19%
Winklehner et al. Eur Radiol 2015;25:2346-53
Automated tube voltage selection
FLASH FORCE FLASH FORCE
CNR: +20%
FLASH FORCE
Winklehner et al. Eur Radiol 2015;25:2346-53
Automated tube voltage selection
100 kVp 90 kVp
dose: -22%
Winklehner et al. Eur Radiol 2015;25:2346-53
Automated tube voltage selection
synopsis
Automated tube voltage selection
- CT Angiography
Cardiac CT
- Turbo flash mode
CT Angiography
- low contrast media volume examinations
Cardiovascular CT: tomorrow ?
ex-vivo experiment: moving phantom with coronaries
Morsbach et al. Eur Radiol 2014;24:1889-95
Cardiac CT
bpm
37-year-old man w atypical chest pain
Cardiac CT – higher heart rates - example
Klingenberg et al., Eur Heart J 2015;36:1001
op
tica
l co
he
rence to
mo
gra
phy
, 83bpm, spiral mode, 4.1mSv
synopsis
Automated tube voltage selection
- CT Angiography
Cardiac CT
- Turbo flash mode
CT Angiography
- low contrast media volume examinations
Cardiovascular CT: tomorrow ?
Single-energy CTA – kVp dependent CM protocol
Higashigaito K, et al. Invest Radiol 2015 Dec 5. [Epub ahead of print]
Single-energy CTA – kVp dependent CM protocol
Higashigaito K, et al. Invest Radiol 2015 Dec 5. [Epub ahead of print]
coronary artery bypass grafts
Single-energy CTA – kVp dependent CM protocol
Higashigaito K, et al. Invest Radiol 2015 Dec 5. [Epub ahead of print]
coronary artery bypass grafts
Single-energy CTA – kVp dependent CM protocol
Higashigaito K, et al. Radiology 2016, in press
CTA of the aorta with high-pitch
Dual-energy approach – mono +
Meier A, et al. Clin Radiol. 2015 Jul 28 [Epub ahead of print]
conventional monoenergetic reconstruction
mono +
synopsis
Automated tube voltage selection
- CT Angiography
Cardiac CT
- Turbo flash mode
CT Angiography
- low contrast media volume examinations
Cardiovascular CT: tomorrow ?
Adenosin MRI
Adenosin CT (40 ml contrast media, 70 kVp, 2.5 mSv)
Functional imaging: myocardial perfusion with CT
Courtesy of T. Henzler, Unversitätsmedizin Mannheim, Germany
Functional imaging: dynamic CT angiography