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Christoph R Becker

Publications and source records attributed to Christoph R Becker.

63 records · Page 4Linked to original sources

Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation.

Our objective was to evaluate image quality and radiation exposure of retrospectively ECG-gated multislice helical CT (MSCT) investigations of the heart with ECG-controlled tube current modulation. One hundred patients underwent MSCT scanning (Somatom VolumeZoom, Siemens, Forchheim, Germany) for detection of coronary artery calcifications. A continuous helical data set of the heart was acquired in 50 patients (group 1) using the standard protocol with constant tube current, and in 50 patients (group 2) using an alternative protocol with reduced radiation exposure during the systolic phase. The standard deviations (SD) of predefined regions of interest (ROIs) were determined as a measure of image noise and were tested for significant differences. There was no significant difference between group 1 and group 2 with respect to image noise. Radiation exposure with and without tube current modulation was 1.0 and 1.9 mSv ( p<0.0001), respectively, for males and 1.4 and 2.5 mSv ( p<0.0001), respectively, for females; thus, there was a mean dose reduction of 48% for males and 45% for females, respectively. The ECG-controlled tube current modulation allows significant dose reduction when performing retrospectively ECG-gated MSCT of the heart.

Calcinosis↗

Assessment of coronary arteries with CT.

This article is designed to provide the reader information about the technical details of retrospective ECG-gated spiral 4SCT and its applications for the detection and quantification of coronary artery calcification, the detection of coronary artery stenoses, and the characterization of coronary atherosclerotic plaques.

Coronary Angiography↗

Subsegmental pulmonary emboli: improved detection with thin-collimation multi-detector row spiral CT.

PURPOSE: To compare different reconstruction thicknesses of thin-collimation multi-detector row spiral computed tomographic (CT) data sets of the chest for the detection of subsegmental pulmonary emboli. MATERIALS AND METHODS: A multi-detector row spiral CT protocol for the diagnosis of pulmonary embolism was used that consisted of scanning the entire chest with 1-mm collimation within one breath hold. In 17 patients with central pulmonary embolism, the raw data were used to perform reconstructions with 1-mm, 2-mm, and 3-mm section thicknesses. For each set of images, each subsegmental artery was independently graded by three radiologists as open, containing emboli, or indeterminate. RESULTS: For the rate of detection of emboli in subsegmental pulmonary arteries, use of the 1-mm section width yielded an average increase of 40% when compared with the use of 3-mm-thick sections (P <.001) and of 14% when compared with the use of 2-mm-thick sections (P =.001). With the use of 1-mm sections versus 3-mm sections, the number of indeterminate cases decreased by 70% (P =.001). Interrater agreement was substantially better with the use of 1-mm and 2-mm sections than with the use of 3-mm sections. CONCLUSION: For the diagnosis of subsegmental pulmonary emboli at multi-detector row CT, the use of 1-mm section widths results in substantially higher detection rates and greater agreement between different readers than the use of thicker sections.

Adult↗

Coronary artery calcium: absolute quantification in nonenhanced and contrast-enhanced multi-detector row CT studies.

PURPOSE: (a) To determine the accuracy of multi-detector row computed tomography (CT) in the measurement of the calcium concentration in a cardiac CT calibration phantom and (b) to assess the correlation of a traditional 3-mm section width CT coronary screening protocol and a 1.25-mm section width CT angiography imaging protocol in the quantification of the absolute mass of coronary calcium in patients who underwent both coronary screening and CT angiography with a multi-detector row CT scanner. MATERIALS AND METHODS: A heart phantom containing calcified cylinders was scanned to determine calibration factors and absolute calcium mass. In 50 patients, the variability (value 1 - value 2/mean value 1 - value 2), limit of agreement (+/-2SD value 1 - value 2), and systematic error (mean value 1 - value 2) of the total amount of coronary calcium calculated at traditional 3-mm section width CT and at 1.25-mm section width CT angiography were determined. RESULTS: The correlation coefficient between the 3-mm section width, nonenhanced protocol and the 1.25-mm section width CT angiography protocol was very high (r = 0.977) and the mean variability was low (19.7%) for the absolute mass. There was a systematic error of -6.7 mg and a limit of agreement between 45.0 mg and -58.5 mg. CONCLUSION: Use of the mass quantification algorithm in combination with a calibration phantom allows accurate quantification of coronary calcium. Measurements of calcium mass obtained at 1.25-mm section width CT angiography have the best agreement with those obtained at the traditional 3-mm section width imaging protocol.

Algorithms↗

The mineralization patterns at the subchondral bone plate of the glenoid cavity in healthy shoulders.

The distribution of mineralization of the subchondral bone plate (DMSB) is used as a parameter for the individual stress distribution of joints. In this study the DMSB of the glenoid from healthy glenohumeral joints was analyzed. In a standardized manner, 44 macroscopically normal shoulder specimens (28 individuals aged 18 to 96 years) were selected and DMSB of the glenoid was evaluated by computed tomography osteoabsorptiometry. The mineralization patterns were described, and the 2 most frequent maxima of density were localized and statistically assessed to analyze any influence of age, side, or shape of the glenoid on DMSB. An anterior-superior maximum was found in 100% and a posterior maximum in 82%. Three different patterns of DMSB were distinguished in relation to the constant anterior-superior maximum: 68% were not combined with a further central or anterior-inferior maximum (type A), whereas a central maximum coexisted in 18% (type B) and an anterior-inferior maximum in 14% (type C). The localization of the anterior-superior and posterior maxima was independent of age or side of the glenoid, indicating a constant long-term stress distribution in healthy glenohumeral joints. The typical localization of the density maxima showed that stress distribution is usually peripherical (82%) and often bicentric. Functional aspects related to internal rotation of the arm support a more constant anterior than posterior stress on the glenoid surface.

Cadaver↗

Detection of coronary artery stenoses with multislice helical CT angiography.

OBJECTIVES: The authors compared multislice CT angiography and selective angiography for the assessment of coronary artery disease. METHODS: In 28 patients, the presence and degree of coronary artery stenoses were determined in coronary segments prepared with beta-blocker for good image quality with multislice CT. RESULTS: In 187 coronary artery segments, sensitivity, specificity, and negative predictive value for the detection of stenoses >50% with multislice CT angiography were 81%, 90%, and 97%, respectively. The agreement for determining the degree of stenoses with multislice CT angiography and selective coronary angiography was only moderate (kappa = 0.58). CONCLUSIONS: Because of the limited spatial resolution, it is not possible with multislice CT angiography to determine the degree the coronary artery stenoses precisely. However, the high negative predictive value indicates that multislice CT may be a suitable tool to reliably rule out coronary artery disease.

Aged↗

Assessment of myocardial infarctions using multidetector-row computed tomography.

OBJECTIVE: To evaluate the diagnostic power of contrast-enhanced multidetector-row computed tomography (MDCT) in assessing the presence, age, and size of myocardial infarctions. METHODS: One hundred six patients underwent standard MDCT coronary angiography without additional changes in the protocol. In all patients, a complete patient history and left heart catheterization with biplane contrast ventriculography were available. The MDCT images were reviewed for the presence and age of myocardial infarctions in a blinded fashion. Infarct areas were detected as regions of reduced uptake of contrast in the early arterial phase and/or regional wall thinning. Reviewing the computed tomography (CT) images, CT density values (Hounsfield units [HU]) were measured at the site of infarcted and noninfarcted myocardium, and a volumetric assessment of the infarct size was performed. RESULTS: In 27 of 106 patients, myocardial infarctions were present. Multidetector-row computed tomography detected 23 of 27 infarctions (sensitivity of 85%, specificity of 91%, and accuracy of 90%). Comparing the HU of infarcted versus noninfarcted myocardium, the mean HU of infarcted areas was 54 +/- 19 HU versus 117 +/- 28 HU for noninfarcted myocardium (P < 0.01). Multidetector-row computed tomography was able to differentiate between recent and chronic infarctions. The infarct volumes of recent infarctions (6.3 +/- 3.6 cm) showed a negative correlation to the ejection fraction (EF) according to contrast ventriculography (ie, the larger the infarct volumes as measured using MDCT, the worse was the EF [r = -0.72, P < 0.01]). CONCLUSIONS: Performing standard MDCT coronary angiography, areas of infarcted myocardium can be identified with moderate to high sensitivity, without additional scanning or contrast administration. Infarct localization can be assessed accurately as compared with cineventriculography. To some degree, infarct age and infarct volume can be estimated.

Aged↗

Assessment of global left ventricular function: comparison of cardiac multidetector-row computed tomography with angiocardiography.

OBJECTIVE: Evaluation of left ventricular function using electrocardiogram (ECG)-gated multidetector row CT (MDCT) by using 3 different volumetric assessment methods in comparison to assessment of the left ventricular function by invasive ventriculography. METHODS: Thirty patients with suspected or known coronary artery disease underwent MDCT coronary angiography with retrospective ECG cardiac gating. Raw data were reconstructed at the end-diastolic and end-systolic periods of the heart cycle. To calculate the volumes of the left ventricle, 3 methods were applied: The 3-dimensional data set (3D), the geometric hemisphere cylinder (HC), and the geometric biplane ellipsoid (BE) methods. End-diastolic volumes (EDV), end-systolic volumes (ESV), the stroke volumes (SV), and ejection fractions (EF) were calculated. The left ventricular volumetric data from the 3 methods were compared with measurements from left ventriculography (LVG). RESULTS: The best results were obtained using the 3D method; EDV (r = 0.73), ESV (r = 0.88), and EF (r = 0.76) correlated well with the LVG data. The EDV volumes did not differ significantly between LVG and the 3D method (P = 0.24); however, ESV, SV, and EF differed significantly. The ESV were significantly overestimated (P < 0.01), leading to an underestimation of the SV (P < 0.01) and the EF (P < 0.01). The HC method resulted in the greatest overestimation of the volumes. The EDV and the ESV were 31.8 +/- 37.6% and 136.4 +/- 92.9% higher than the EDV and ESV volumes obtained by LVG. Bland-Altman analysis showed systematic overestimation of the ESV using the HC method. CONCLUSION: MDCT with retrospective cardiac ECG gating allows the calculation of left ventricular volumes to estimate systolic function. The 3D method had the highest correlation with LVG. However, the overestimation of the ESV is significant, which led to an underestimation of the SV and the EF.

Adult↗