Image quality of low-radiation dose left atrial CT using filtered back projection and an iterative reconstruction algorithm: intra-individual comparison in unselected patients undergoing pulmonary vein isolation

Acta Radiologica
Ute Lina FahlenkampAlexander Lembcke

Abstract

Background Computed tomography (CT) of the left atrium (LA) is performed prior to pulmonary vein isolation (PVI) to improve success of circumferential ablation for atrial fibrillation. The ablation procedure itself exposes patients to substantial radiation doses, therefore radiation dose reduction in pre-ablational imaging is of concern. Purpose To assess and compare diagnostic performance of low-radiation dose preprocedural CT in patients scheduled for PVI using two types of reconstruction algorithms. Material and Methods Forty-six patients (61 ± 10 years) scheduled for PVI were enrolled in this study irrespective of body-mass-index or cardiac rhythm at examination. An electrocardiographically triggered dual-source CT scan was performed. Filtered back projection (FBP) and iterative reconstruction (IR) algorithms were applied. Images were integrated into an electroanatomic mapping (EAM) system. Subjective image quality was scored independently by two readers on a five-point scale for both reconstruction algorithms (1 = excellent to 5 = non-diagnostic). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and effective radiation dose were calculated. Results Data acquisition and EAM integration were successful in all pati...Continue Reading

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