Variations of skin thermal diffusivity on different skin regions.

BACKGROUND AND OBJECTIVE: Skin thermal diffusivity plays a crucial role in various applications, including laser therapy and cryogenic skin cooling.This study investigates the correlation between skin thermal diffusivity and two important skin parameters, melanin content and erythema, in a cohort of 102 participants. METHODS: An in-house developed device based on transient temperature measurement was used to assess thermal diffusivity at different body locations. Melanin content and erythema were measured using a colorimeter. Statistical analysis was performed to examine potential correlations. RESULTS: The results showed that the measured thermal diffusivity values were consistent with previous reports, with variations observed among subjects. No significant correlation was found between thermal diffusivity and melanin content or erythema. This suggests that other factors, such as skin hydration or epidermis thickness, may have a more dominant influence on skin thermal properties. CONLCUSION: This research provides valuable insights into the complex interplay between skin thermal properties and physiological parameters, with potential implications for cosmetic and clinical dermatology applications.

Image quality and radiation dose comparison of prospectively triggered low-dose CCTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition.

Currently 64-multislice computed tomography (MSCT) scanners are the most widely used devices allowing low radiation dose coronary CT angiography (CCTA) with prospective ECG triggering. Latest 128-slice dual-source CT (DSCT) scanners offer prospective high-pitch spiral acquisition covering the heart during one single beat. We compared radiation dose and image quality from prospective 64-MSCT versus high-pitch spiral 128-slice DSCT scanning, as such data is lacking. CCTA of 50 consecutive patients undergoing 128-DSCT (2 × 64 × 0.6 mm collimation, 0.28 s rotation time, 3.4 pitch, 100-120 kV tube voltage and 320 mAs tube current-time product) were compared to CCTA of 50 heart rate (HR) and BMI matched patients undergoing 64-MSCT (64 × 0.625 mm collimation, 0.35 s rotation time, 100-120 kV tube voltage and 400-650 mA tube current). Image quality was rated on a 4-point scale by two independent cardiac imaging physicians (1 = excellent to 4 = non-diagnostic). Of 710 coronary segments assessed on 128-DSCT, 216 (30.4%) achieved an image quality score 1 excellent, 400 (56.3%) score 2, 76 (10.7%) score 3 and 18 (2.6%) score 4 (non-diagnostic). Of 737 coronary segments evaluated on 64-MSCT 271 (36.8%) had an image quality score of 1, 327 (44.4%) 2, 110 (14.9%) score 3, and 29 (3.9%) segments score 4. Average image quality score for both scanners was similar (P = 0.641). The mean heart rate during scanning was 58.7 ± 5.6 bpm on 128-DSCT and 59.0 ± 5.6 bpm on 64-MSCT, respectively. Mean effective radiation dose was 1.0 ± 0.2 mSv for 128-DSCT and 1.7 ± 0.6 mSv for 64-MSCT (P < 0.001). 128-DSCT with high-pitch spiral mode allows CCTA acquisition with reduced radiation dose at maintained image quality compared to 64-MSCT.

Low-dose computed tomography coronary angiography with prospective electrocardiogram triggering: feasibility in a large population.

OBJECTIVES: We sought to assess the feasibility of prospective electrocardiogram triggering for achieving low-dose computed tomography coronary angiography (CTCA) in a large population. BACKGROUND: Prospective electrocardiogram triggering dramatically reduces radiation exposure for CTCA but requires heart rate (HR) control to obtain diagnostic image quality. Its feasibility in daily clinical routine has therefore remained to be elucidated. METHODS: We evaluated 612 patients consecutively referred for CTCA by 64-slice computed tomography. Intravenous metoprolol (2 to 30 mg) was administered if necessary to achieve a target HR below 65 beats/min. Image quality was assessed on a semiquantitative 4-point scale for each coronary segment. RESULTS: Forty-six (7.5%) patients were deemed ineligible due to irregular heart rhythm (n = 19), insufficient response to metoprolol (n = 21), renal insufficiency (n = 3), or inability to follow breath-hold commands (n = 3). Mean effective radiation dose was 1.8 ± 0.6 mSv with a diagnostic image quality in 96.2% of segments. Finally, low-dose CTCA allowed a firm diagnosis with regard to the presence or absence of coronary artery disease in 527 (86.1%) patients. Intravenous metoprolol to achieve an HR below 65 beats/min was used in 64.4% of patients. Incidence of nondiagnostic segments was inversely related to HR (r = -0.809, p < 0.001). Below an HR cutoff of 62 beats/min, only 1.2% of coronary segments were nondiagnostic. CONCLUSIONS: Low-dose CTCA by electrocardiogram triggering is feasible in the vast majority of an every-day population. However, HR control is crucial, as an HR below 62 beats/min favors diagnostic image quality.

Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering.

In patients with large total blood volume contrast material (CM) dilution decreases coronary attenuation in CT coronary angiography (CTCA). As increased blood volume is well paralleled by body surface area (BSA) we assessed a BSA-adapted CM protocol to compensate for dilution effects. Low-dose CTCA with prospective ECG-triggering was performed in 80 patients with a BSA-adapted CM bolus ranging 40-105 ml and injection rate ranging 3.5-5.0 ml/s for a BSA of <1.70 to >or=2.5 m(2). Eighty control patients matched for BSA who had previously undergone routine CTCA with a fixed CM protocol of 80 ml at 5 ml/s served as reference group. The average vessel attenuation from the proximal right (RCA) and the left main coronary artery (LMA) was assessed. Correlation of BSA with vessel attenuation was assessed in both groups. BSA-matching of all patients was successful (BSA-adapted group 1.98 +/- 0.15 m(2), range 1.66-2.39 m(2) versus reference group 1.98 +/- 0.17 m(2), range 1.59-2.38 m(2); P = 0.74). Mean CM bolus was significantly smaller in the BSA-adapted versus the reference group (70.9 +/- 14.1 vs. 80.0 +/- 0 ml, P < 0.001). There was no correlation in the BSA-adapted group (r = -0.07, P = 0.53, SEE = 0.15), while coronary attenuation was inversely related to BSA in the reference group (r = -0.59, P < 0.001, SEE = 0.14). We have successfully validated a BSA-adapted contrast material protocol which results in a comparable coronary contrast enhancement independent of individual BSA. This was achieved despite a significant reduction in the overall contrast material amount.

Ultrafast nuclear myocardial perfusion imaging on a new gamma camera with semiconductor detector technique: first clinical validation.

PURPOSE: To assess the diagnostic performance of a novel ultrafast cardiac gamma camera with cadmium-zinc-telluride (CZT) solid-state semiconductor detectors for nuclear myocardial perfusion imaging (MPI). METHODS: The study group comprised 75 consecutive patients (55 men, BMI range 19-45 kg/m(2)) who underwent a 1-day (99m)Tc-tetrofosmin adenosine-stress/rest imaging protocol. Scanning was performed first on a conventional dual-detector SPECT gamma camera (Ventri, GE Healthcare) with a 15-min acquisition time each for stress and rest. All scans were immediately repeated on an ultrafast CZT camera (Discovery 530 NMc, GE Healthcare) with a 3-min scan time for stress and a 2-min scan time for rest. Clinical agreement (normal, ischaemia, scar) between CZT and SPECT was assessed for each patient and for each coronary territory using SPECT MPI as the reference standard. Segmental myocardial tracer uptake values (percent of maximum) using a 20-segment model and left ventricular ejection fraction (EF) values obtained using CZT were compared with those obtained using conventional SPECT by intraclass correlation and by calculating Bland-Altman limits of agreement. RESULTS: There was excellent clinical agreement between CZT and conventional SPECT on a per-patient basis (96.0%) and on a per-vessel territory basis (96.4%) as shown by a highly significant correlation between segmental tracer uptake values (r=0.901, p<0.001). Similarly, EF values for both scanners were highly correlated (r=0.976, p<0.001) with narrow Bland-Altman limits of agreement (-5.5-10.6%). CONCLUSION: The novel CZT camera allows a more than fivefold reduction in scan time and provides clinical information equivalent to conventional standard SPECT MPI.

Usefulness of additional coronary calcium scoring in low-dose CT coronary angiography with prospective ECG-triggering impact on total effective radiation dose and diagnostic accuracy.

RATIONALE AND OBJECTIVES: To determine the impact of additional coronary calcium scoring on total effective radiation dose and diagnostic accuracy of low-dose computed tomography coronary angiography (CTCA) with prospective electrocardiogram (ECG) triggering. MATERIALS AND METHODS: Sixty-one consecutive patients underwent 64-slice CTCA using prospective ECG triggering, calcium scoring, and invasive quantitative coronary angiography, the latter served as standard of reference. Diagnostic accuracy was calculated for CTCA, calcium scoring, and for the combination of both. Receiver operator characteristic analyses were performed to determine cutoffs for prediction of significant coronary artery stenoses. RESULTS: Mean effective radiation dose was 2.1 + or - 0.7 mSv (range, 1.0-3.3 mSv) for CTCA and 1.1 + or - 0.1 mSv (range, 0.9-1.4 mSv) for calcium scoring. Per-patient sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 85.7%, 89.2%, and 100% for CTCA, and 72.7%, 82.1%, 82.8%, and 71.9% for calcium scoring. Adding calcium-scoring with a cutoff at 133 in patients aged >50.7 years with nondiagnostic CTCA improved the respective values of diagnostic accuracy of the entire study population to 100%, 96.4%, 97.1%, and 100%; the added value of calcium scoring was confined to only three patients (5%), who were reclassified from false positive to true negative. CONCLUSION: Specificity and PPV of low-dose CTCA may be further improved by combining it with coronary calcium scoring. However, only a fraction of patient may benefit, whereas exposing the entire population to more than 50% increase in effective radiation dose.