Objectives: Multidetector CT (MDCT) is a valuable tool for functional prosthetic heart valve (PHV) assessment. However, radiation exposure remains a concern. We assessed a novel CT-acquisition protocol for comprehensive PHV evaluation at limited dose. Methods: Patients with a PHV were scanned using a third-generation dual-source CT scanner (DSCT) and iterative reconstruction technique (IR). Three acquisitions were obtained: a non-enhanced scan; a contrast-enhanced, ECG-triggered, arterial CT angiography (CTA) scan with reconstructions at each 5 % of the R-R interval; and a delayed high-pitch CTA of the entire chest. Image quality was scored on a five-point scale. Radiation dose was obtained from the reported CT dose index (CTDI) and dose length product (DLP). Results: We analysed 43 CT examinations. Mean image quality score was 4.1±1.4, 4.7±0.5 and 4.2±0.6 for the non-contrast-enhanced, arterial and delayed acquisitions, respectively, with a total mean image quality of 4.3±0.7. Mean image quality for leaflet motion was 3.9±1.4. Mean DLP was 28.2±17.1, 457.3±168.6 and 68.5±47.2 mGy.cm for the non-contrast-enhanced (n=40), arterial (n=43) and delayed acquisition (n=43), respectively. The mean total DLP was 569±208 mGy.cm and mean total radiation dose was 8.3±3.0 mSv (n=43). Conclusion: Comprehensive assessment of PHVs is possible using DSCT and IR at moderate radiation dose. Key points: • Prosthetic heart valve dysfunction is a potentially life-threatening condition.• Dual-source CT can adequately assess valve leaflet motion and anatomy.• We assessed a comprehensive protocol with three acquisitions for PHV evaluation.• This protocol is associated with good image quality and limited dose.

Additional Metadata
Keywords Cardiac imaging, Computed tomography, Image quality, Prosthetic heart valve, Radiation dose
Persistent URL dx.doi.org/10.1007/s00330-017-5163-7, hdl.handle.net/1765/103468
Journal European Radiology: journal of the European Congress of Radiology
Citation
Faure, M.E. (Marguerite E.), Swart, L.E, Dijkshoorn, M.L, Bekkers, J.A, van Straten, M, Nieman, K, … Budde, R.P.J. (2017). Advanced CT acquisition protocol with a third-generation dual-source CT scanner and iterative reconstruction technique for comprehensive prosthetic heart valve assessment. European Radiology: journal of the European Congress of Radiology, 1–10. doi:10.1007/s00330-017-5163-7