Prevalence of extracardiac findings in patients undergoing coronary computed tomography and additional low-dose whole-body computed tomography

Jpn J Radiol. 2020 Feb;38(2):144-153. doi: 10.1007/s11604-019-00906-3. Epub 2019 Dec 20.

Abstract

Purpose: In patients with suspected coronary artery disease (CAD), coexisting extracardiac abnormalities have a major impact on the patient management. This study aimed to evaluate the image quality of whole-body computed tomography (CT) immediately after the coronary computed tomography angiography (CTA) and investigate the incidence of extracardiac findings in patients with suspected CAD.

Materials and methods: We enrolled 450 patients undergoing whole-body CT at 100 kVp and model-based iterative reconstruction immediately after the coronary CTA (Group A) and retrospectively reviewed 144 control patients who underwent conventional contrast-enhanced CT (120 kVp) with filtered back projection (Group B). We compared the signal-to-noise ratio (SNR) of the aorta and liver and radiation dose between the two groups. Then, we evaluated the prevalence of extracardiac findings in Group A.

Results: Compared with Group B, Group A demonstrated significantly higher aorta and liver SNR and lower radiation dose. In Group A, whole-body CT revealed 229 coexisting lesions in 165 patients, including 32 and 106 cases of oncologic and vascular diseases, respectively.

Conclusion: Additional whole-body CT after coronary CTA may provide adequate image quality. Using additional whole-body CT, 36% of patients with suspected CAD had clinically relevant coexisting findings, including malignancy.

Keywords: Atherosclerotic lesions; Coronary computed tomography; Extracardiac findings; Onco-cardiology.

MeSH terms

  • Aged
  • Computed Tomography Angiography / methods*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Radiation Dosage*
  • Retrospective Studies
  • Signal-To-Noise Ratio
  • Tomography, X-Ray Computed / methods
  • Whole Body Imaging / methods*