Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study

Introduction: The present study sought to compare the diagnostic accuracy and radiation dose of ECG-gated, ultra-fast, low-dose, high-pitch, spiral (FLASH) mode versus conventional, ECG-gated, sequential coronary artery calcium (CAC) scoring in patients with suspected coronary artery disease (CAD)....

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Main Authors: Niraj Nirmal Pandey, Sayannika Chakraborty, Mansi Verma, Priya Jagia
Format: Article
Language:English
Published: Tabriz University of Medical Sciences 2024-03-01
Series:Journal of Cardiovascular and Thoracic Research
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Online Access:https://jcvtr.tbzmed.ac.ir/PDF/jcvtr-16-15.pdf
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author Niraj Nirmal Pandey
Sayannika Chakraborty
Mansi Verma
Priya Jagia
author_facet Niraj Nirmal Pandey
Sayannika Chakraborty
Mansi Verma
Priya Jagia
author_sort Niraj Nirmal Pandey
collection DOAJ
description Introduction: The present study sought to compare the diagnostic accuracy and radiation dose of ECG-gated, ultra-fast, low-dose, high-pitch, spiral (FLASH) mode versus conventional, ECG-gated, sequential coronary artery calcium (CAC) scoring in patients with suspected coronary artery disease (CAD). Methods: The study included 120 patients who underwent both conventional scanning and FLASH mode scanning and were subdivided into derivation and validation cohorts. In the conventional sequential (step-and-shoot) protocol, prospective ECG-gated, non-contrast acquisition was performed at 70% of R-R interval. The spiral (FLASH) mode utilized a high-pitch and high-speed gantry rotation scanning mode where acquisition of the entire heart was done within a single cardiac cycle with prospective ECG-gating at 70% of R-R interval. Results: Correlation between CAC scores derived from conventional (cCAC) and FLASH mode (fCAC) in derivation cohort was excellent (r=0.99; P<0.001). A linear regression model was used to develop a formula for deriving the estimated CAC score (eCAC) from fCAC (eCAC=0.978 x fCAC). In validation cohort, eCAC showed excellent agreement with cCAC (ICC=0.9983; 95%CI: 0.9972 - 0.9990). Excellent agreement for risk classification (weighted kappa=0.93898; 95%CI: 0.86833 - 1.0000) was observed with 95% (57/60) scores falling within the same risk category. Effective dose was significantly lower in FLASH mode (conventional, 0.58±0.21 mSv vs. FLASH, 0.34±0.12 mSv; P<0.0001). Conclusion: CAC scoring using FLASH mode is feasible with high accuracy and shows excellent agreement with conventional CAC scores at significantly reduced radiation doses.
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2008-6830
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publisher Tabriz University of Medical Sciences
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spelling doaj-art-9af64ead80e545629caaa8a2efcca14e2025-08-20T02:32:57ZengTabriz University of Medical SciencesJournal of Cardiovascular and Thoracic Research2008-51172008-68302024-03-01161152010.34172/jcvtr.31736jcvtr-31736Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation studyNiraj Nirmal Pandey0Sayannika Chakraborty1Mansi Verma2Priya Jagia3Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, IndiaIntroduction: The present study sought to compare the diagnostic accuracy and radiation dose of ECG-gated, ultra-fast, low-dose, high-pitch, spiral (FLASH) mode versus conventional, ECG-gated, sequential coronary artery calcium (CAC) scoring in patients with suspected coronary artery disease (CAD). Methods: The study included 120 patients who underwent both conventional scanning and FLASH mode scanning and were subdivided into derivation and validation cohorts. In the conventional sequential (step-and-shoot) protocol, prospective ECG-gated, non-contrast acquisition was performed at 70% of R-R interval. The spiral (FLASH) mode utilized a high-pitch and high-speed gantry rotation scanning mode where acquisition of the entire heart was done within a single cardiac cycle with prospective ECG-gating at 70% of R-R interval. Results: Correlation between CAC scores derived from conventional (cCAC) and FLASH mode (fCAC) in derivation cohort was excellent (r=0.99; P<0.001). A linear regression model was used to develop a formula for deriving the estimated CAC score (eCAC) from fCAC (eCAC=0.978 x fCAC). In validation cohort, eCAC showed excellent agreement with cCAC (ICC=0.9983; 95%CI: 0.9972 - 0.9990). Excellent agreement for risk classification (weighted kappa=0.93898; 95%CI: 0.86833 - 1.0000) was observed with 95% (57/60) scores falling within the same risk category. Effective dose was significantly lower in FLASH mode (conventional, 0.58±0.21 mSv vs. FLASH, 0.34±0.12 mSv; P<0.0001). Conclusion: CAC scoring using FLASH mode is feasible with high accuracy and shows excellent agreement with conventional CAC scores at significantly reduced radiation doses.https://jcvtr.tbzmed.ac.ir/PDF/jcvtr-16-15.pdfcoronary artery diseasecoronary angiographycardiac-gated imaging techniques
spellingShingle Niraj Nirmal Pandey
Sayannika Chakraborty
Mansi Verma
Priya Jagia
Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
Journal of Cardiovascular and Thoracic Research
coronary artery disease
coronary angiography
cardiac-gated imaging techniques
title Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
title_full Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
title_fullStr Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
title_full_unstemmed Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
title_short Low-dose, high-pitch, spiral (FLASH) mode versus conventional sequential method for coronary artery calcium scoring: A derivation-validation study
title_sort low dose high pitch spiral flash mode versus conventional sequential method for coronary artery calcium scoring a derivation validation study
topic coronary artery disease
coronary angiography
cardiac-gated imaging techniques
url https://jcvtr.tbzmed.ac.ir/PDF/jcvtr-16-15.pdf
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AT mansiverma lowdosehighpitchspiralflashmodeversusconventionalsequentialmethodforcoronaryarterycalciumscoringaderivationvalidationstudy
AT priyajagia lowdosehighpitchspiralflashmodeversusconventionalsequentialmethodforcoronaryarterycalciumscoringaderivationvalidationstudy