Clinical examination protocols with 4- to 64-slice CT

Abstract

This chapter gives an overview of the scan protocols for the main cardiac imaging applications and for the various multi-slice CT technology levels that are in regular clinical use today. More protocols that are used in specific patient populations or under research conditions can be also found in Chap. 7. The first multi-slice cardiac CT imaging protocols were already developed in 1999 (Ohnesorge 2000) for a broad range of clinical applications based on the first available 4-slice CT scanners. These represent the minimum technology level that is required for basic cardiac applications, such as coronary calcium scoring and display of the larger cardiac anatomy. More advanced applications, such as coronary artery diagnosis and assessment of cardiac function, have become feasible with the more recent introduction of 16- to 64-slice CT scanners with increased spatial and temporal resolution and shorter breath-hold times (Lawler 2004, Schoepf 2004, Schoenhagen 2004, Ohnesorge 2005, Flohr 2005, Gaspar 2005, Schoepf 2006, Lardo 2006). The protocols presented in this chapter are designed to provide a suitable balance of best possible clinical outcome, on the one hand, and minimum possible radiation exposure, on the other. The given parameters apply for a wide range of CT scanners from all major manufacturers and also indicate the minimum technology level needed for a certain clinical application. Where feasible, different protocol options using prospective ECG triggering or retrospective ECG gating are introduced, and the advantages and disadvantages discussed. For contrast- enhanced applications, we provide suggestions for contrast-agent protocols with optimized timing of vascular and anatomical enhancement. The discussion of clinical indications and evaluation techniques is not the subject of this chapter but of other chapters in this book. © 2007 Springer-Verlag Berlin Heidelberg.