Mickael Ohana MD, MSc, Presenter: Nothing to Disclose

Aissam Labani MD, Abstract Co-Author: Nothing to Disclose

Soraya El Ghannudi-Abdo MD, Abstract Co-Author: Nothing to Disclose

Mi-Young Jeung MD, Abstract Co-Author: Nothing to Disclose

Karim Haioun, Abstract Co-Author: Employe, Toshiba Corporation

Patrick Ohlmann MD, PhD, Abstract Co-Author: Nothing to Disclose

Catherine Roy MD, Abstract Co-Author: Nothing to Disclose

Reduce the iodine load required for CT TAVI planning by acquiring the ECG-gated aortic root volume and the non-gated aortoiliac scan within the same single contrast media bolus injection.

50 patients (60% women, 83yo ±7) were prospectively included and underwent TAVI planning with a second-generation 320-row CT scanner. The aortic root was acquired in volume mode using retrospective ECG-gating (100kV, 0.275s rotation time, 2 beats maximum) and immediately followed by a non-gated CAP aortic ultra-fast helical acquisition (100kV, 0.275s rotation time, pitch=0.813), all within a single bolus of 40 to 70mL of Iohexol 350mgI/mL. Image quality of both cardiac and aortic acquisitions was independently assessed by two radiologists on a qualitative five-point scale, and HU enhancement measured in the aorta and the iliac arteries to calculate the signal to noise (SNR) and contrast to noise ratios (CNR). These qualitative and quantitative results were compared to 24 procedures (62% women, 84yo ±5) previously performed on a 64-row scanner with a conventional two-step protocol using two contrast media boluses. Qualitative results were analyzed by a Kruskal-Wallis nonparametric test and quantitative data were compared using a Mann-Whitney test. A p<0.05 was considered significant.  

Mean iodine load was commonsensically significantly lower in the 320-row group (23.1g±3.6 vs 43.2g ±8, p<0.01). Image quality of the ECG-gated aortic root and the CAP aorta were equivalent (respectively 4.9 and 4.7 vs 4.4 and 4.9, p>0.05). Mean HU enhancement was similar (388 vs 400, p=0.4) while mean noise was significantly lower (24.5 vs 28.5, p<0.01), leading to a slightly improved SNR and CNR (16.3 and 13.9 vs 14.7 and 12.5, p=0.34 and 0.57). Radiation dose was significantly lower for both the ECG-gated acquisition (547mGy.cm vs 800, p<0.01) and the whole-body aortic scan (487mGy.cm vs 785, p<0.01).  

Second-generation 320-row CT scanner enables a 47% reduction of the iodine load in TAVI planning, by subsequently acquiring the ECG-gated aortic root and the CAP aorta within a single contrast media bolus injection, while maintaining excellent aortoiliac arterial enhancement and lowering radiation dose.

TAVI planning with subsequent acquisition of the ECG-gated aortic root and the non-gated whole-body aorta is possible within a single contrast media injection when using a 320-row CT.

Ohana, M, Labani, A, El Ghannudi-Abdo, S, Jeung, M, Haioun, K, Ohlmann, P, Roy, C, 320-row CT Transcatheter Aortic Valve Implantation Planning Using a Single Reduced Contrast Media Bolus Injection: A Prospective Study on 50 Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003100.html