ISC 2026 | ECG-gated versus non–ECG-gated cardiac CT protocols for identifying cardiac thrombi

I would say that’s still an ongoing discussion. I mean, the difference really is, I won’t go into too much of the technical details, but roughly speaking, the difference is either if you do it gated, meaning it’s triggered by the ECG, you get slightly better image quality because you scan based on the phase that the heart is, based on the ECG, so you can decrease motion artifact. So in terms of non-gated, where you simply do not determine the timing of the scan based on the heart rate, it’s not ECG-triggered, you get slightly better quality of the imaging. Now, the downside is that it takes slightly longer because there’s preparation required. You need to attach the ECG stickers. You need to make sure that the calculations are correct. So while a non-gated scan can be easily tacked onto the routine protocol, and the extra scanning time is merely two seconds, that’s it, you change your protocol but it’s only a matter of two seconds because basically you’re just extending your field of view, there’s slightly more to it, but basically that’s it. An ECG-triggered scan will take you, the scanning itself won’t take long, but including the preparations, it’ll probably take you around five to six minutes in addition to the scan protocol. So I would say that those are probably the main differences. You get slightly better image quality, but it takes you slightly more time if you do it triggered. I guess it depends on your hospital situation, experience with both capabilities of the hardware, experience of your radiologist, which of these you’re going to choose. Now, of course, one of the big questions is, is one or the other superior to the other? So the real question would be, is ECG-triggered scanning, because it gives you slightly better quality of the imaging, worth it? Or can we suffice with the non-ECG-gated? And the study that we’re doing, or that we’ve done, gives a first insight into that question, but it doesn’t really answer all the questions because what we’re doing in that study is we’re comparing the yield of the ECG and the non-gated scans because both of them were used in this meta-analysis depending on the center. But of course, the problem is that it’s not the exact patient population, right? So it’ll be slightly difficult to really compare the numbers unless you do it in a head-to-head comparison. So again, I think there are certain differences. Both can be used, but the actual answer is, is one superior to the other, or maybe better said, can we suffice with non-ECG-gated because it is simpler? That needs to be answered in the future, and there’ll be future studies that are going to be looking at it.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.