Perspective:

Coronary CT angiography has been established as an accurate means for evaluating coronary anatomy. Its greatest strength lies in the negative predictive value for subsequent identification of obstructive disease when an entirely normal study is encountered. Limitations of the technique include relatively high contrast load required, limited image quality in the presence of calcium and large body habitus, and the need to control heart rate to avoid motion artifact. One of the major other concerns has been the relatively high radiation exposure associated with CTCA. Earlier generation scanners and imaging protocols often resulted in radiation exposure of 10-15 mSv. Subsequent to the initial studies, multiple advances have been made in imaging protocol such as those presented here, which have reduced the radiation exposure dramatically, as assessed by the average radiation exposure of 1.8 ± 0.06 mSv in this study. Many initial attempts at producing radiation exposure resulted in image degradation in lower likelihood of diagnostic studies. The technique presented in this paper, among other techniques, simultaneously results in lower radiation exposure and preservation of high diagnostic studies. The technique presented here is adaptable to a wide range of currently existing CT platforms and, as such, may see wider acceptance than several other proposed methodologies, which rely on platform-specific imaging.