Document Detail


Applications and limitations of cardiac computed tomography in the evaluation of coronary artery disease.
MedLine Citation:
PMID:  24077228     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Cardiac computed tomography angiography (CCTA) has rapidly emerged in recent years as a promising noninvasive imaging modality for the evaluation of coronary artery disease. This is predominantly because of its proven ability to exclude coronary stenosis in patients without a history of coronary artery disease and with a low-intermediate pre-test likelihood. There is also increasing data on the utility of CCTA in risk stratification and assessment of prognosis. However, it is important to realize the shortcomings of the current technology before advocating its widespread use. Importantly, the utility of CCTA is limited when an abnormal study is anticipated. Because of current limitations on spatial and temporal resolution, CCTA cannot precisely assess the degree of stenosis as compared with invasive coronary angiography. This tendency of CCTA to overestimate stenosis severity along with its the poor positive predictive value can lead to increased downstream testing including additional stress testing and unnecessary invasive coronary angiography. Moreover, despite improvements in technology, the radiation burden of CCTA in real-world clinical practice remains significant. To justify greater use of CCTA in the current healthcare environment, future studies need to demonstrate improvements in patient outcomes, better accuracy compared with established tests, and/or reductions in healthcare costs.
Authors:
Afshin Farzaneh-Far; Michael Steigner; Raymond Y Kwong
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  24     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-09-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  606-12     Citation Subset:  IM    
Affiliation:
aDepartment of Medicine, Section of Cardiology bDepartment of Radiology, University of Illinois at Chicago, Chicago, Illinois cDepartment of Medicine, Division of Cardiology, Duke University Medical Center, Durham, North Carolina Departments of dRadiology eMedicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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