Orlando, Florida – October 7-9, 2011

Update on Cardiac CTAJennifer Dickerson MD

Assistant Professor of Clinical Internal MedicineDirector, The Ohio State University Echocardiography Laboratory

Disclosures

None

Advances in the Field

Evolution of CT scannersDecreasing in radiation exposureDecreasing scan timesNext Frontier

Anatomy with Perfusion

Evolution

1970 1990 1998Axial CT Spiral CT Multislice CT

Maj

or I n

n ova

tion s

in C

T

2005

Body Regions

The 80‘s Axial CT Rotation Time

The 90‘sSpiral CT

CT in 2000Multislice CT

Slice-Number

2s 1s 0.75s

4 16 64

Head Lung Body

2006

Dual Source

Z- Axis

YEAR Slices/

Rotation

Spatial Res.

Temp.

Res.

Scan Time

Coverage

4-Slice 2000 4 1.25mm 250ms ~40s 6mm

16-Slice 2002 16 .75mm 210ms ~20s 12mm

64-Slice 2004 64 .5-.625mm

165ms 5-15s 32mm

DSCT 2006 2x64 .6mm 83ms 7-10s

320 2008 320 .5mm 175ms 1s

256 2008 256 .6mm 135ms 3s 160mm

HDCT 2008 64 .3mm 175ms 5-7s

DSCT-Flash

2009 2x128 .6mm 75ms <1s

Dual Source for Cardiac CTA

Two X-ray tubes at 90°each with 80 kWTwo 64-slice detectors at 90°each with 32x0.6mm collimation and double z-sampling(z-flying focal spot)0.33 s gantry rotation time

DSCT Coronary CT

Courtesy Drs. Achenbach & Küttner, Erlangen University, Germany

Decreasing Radiation Exposure

02468

101214

CXR CTA (2005) Cor Angio SPECT Bkg

Dose mSv

Chen et al: JACC 2010 702-711

Radiation Dose from CTA

Raff, Journal of Cardiovascular CT 2010

ECG gating for dose modulation

A

B

C

Dual Energy Perfusion imaging

Hybrid anatomy and perfusion models

PET CTA 57-year-old man with atypical chest pain during exertion.

Kajander S et al. Circulation 2010;122:603-613

Copyright © American Heart Association

A 69-year-old man with attacks of atypical anginal pain.

Kajander S et al. Circulation 2010;122:603-613

Copyright © American Heart Association