Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner

Abstract

There has been an ongoing debate on the means to minimize the time patients spend at health care providers during the COVID-19 pandemic. We propose a strategy relying solely on intravenous (i.v.) beta-blocker administration for heart-rate (HR) control prior to coronary CT angiography (CCTA). We aimed to assess a potential difference in CCTA image quality (IQ) after implementation of a modified strategy compared to our standard protocol of oral premedication during the first wave of COVID-19. We analyzed CCTA examinations conducted one year before (n = 1511) and after (n = 1064) implementation of this new regime. Examinations were performed both on our 256-slice multidetector CT (MDCT) and dedicated cardiac CT (DCCT) scanners. We used a four-point Likert scale (excellent/good/moderate/non-diagnostic) for IQ assessment of the coronaries. We detected a significant increase in mean HR during examinations on both CT scanners (MDCT: 62.4 ± 10.0 vs. 65.3 ± 9.7, p p p p = 0.38). The improved temporal resolution of DCCT allows the stand-alone use of i.v. premedication with preserved IQ; hence, the duration of visits can be shortened.

Keywords

• CT angiography
• COVID-19
• image quality
• coronary artery disease