Numerous dose-saving strategies have been recommended, and quite a few investigations have shown that radiation dose will be considerably diminished to a level equivalent to (and even decrease than) that from invasive coronary angiography, with out compromising picture high quality [28,29]. ECG-managed tube current modulation is one among the most effective approaches for dose reduction in coronary CT angiography. Effective doses of CCTA as much as 20 mSv have been reported within the literature [29]. Furthermore, the typical dose per site was reported to reveal significant variability, ranging from 5 to 30 mSv [25]. Early research using ECG-controlled tube present modulation reported radiation dose reduction by 30-50% for 4- and 16-slice CT [79,80]. Later reviews with 64-slice and DSCT reported that efficient doses for CCTA could possibly be decreased to lower than 10 mSv with the use of ECG-managed tube current modulation [81,82]. Weustink et al [82] studied three groups of patients with completely different coronary heart rates using DSCT, and their results instructed that radiation dose may very well be considerably decreased with ECG-controlled tube current modulation, particularly in patients with low or excessive heart rate, with the effective dose being 6.8 and 4.2 mSv, respectively.
This open-label, randomized, controlled, parallel-group trial was performed at 12 centers throughout Scotland. The trial, which has been described previously,9,10,13 was conducted with the approval of the South East Scotland Research Ethics Committee. The protocol, available with the total textual content of this text at NEJM.org, was designed by the grant applicants with enter from the trial steering committee (see the Supplementary Appendix, available at NEJM.org).
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