Document Detail


Diagnostic accuracy of coronary computed tomography angiography as interpreted on a mobile handheld phone device.
MedLine Citation:
PMID:  20466343     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study assessed the diagnostic performance of coronary computed tomography angiography (CTA) for the detection and exclusion of significant coronary artery stenosis as remotely interpreted on a mobile handheld device with dedicated medical imaging software. BACKGROUND: Recent advances in technology now permit remote interpretation of medical imaging studies on mobile handheld devices, although the diagnostic performance of this approach is unknown. METHODS: We evaluated 102 patients with stable chest pain and both 64-detector row coronary CTA and quantitative invasive coronary angiography. The diagnostic performance of remote coronary CTA interpretation was assessed using a mobile handheld device and employing dedicated software. The coronary CTA studies were examined in an intent-to-diagnose manner for the presence or absence of coronary artery stenosis > or =50% on a per-artery and per-patient level; results were compared with quantitative invasive coronary angiography. Two blinded imagers independently interpreted coronary CTA studies, with a third imager achieving consensus for discordance. Coronary CTAs were re-interpreted in random order to determine interobserver agreement. Finally, coronary CTAs were evaluated on a dedicated 3-dimensional imaging workstation; results were compared to mobile handheld device findings for intertechnology agreement. RESULTS: The prevalence of significant coronary artery stenosis was 25% (26 of 102) at the per-patient level and 10% (40 of 405) at the per-artery level. Per-patient and per-artery sensitivity, specificity, and positive and negative predictive values were: 100% (26 of 26), 78% (59 of 76), 60% (26 of 43), and 100% (59 of 59), respectively; and 95% (38 of 40), 85% (310 of 365), 41% (38 of 93), and 99% (310 of 312), respectively. At the per-artery level, interobserver, intraobserver, and intertechnology agreement was 0.74, 0.89, and 0.75, respectively (p < 0.01 for all). CONCLUSIONS: The interpretation of coronary CTA using a mobile handheld device with dedicated software for medical image evaluation possesses high diagnostic accuracy for detection and exclusion of significant coronary stenosis.
Authors:
Troy M LaBounty; Robert J Kim; Fay Y Lin; Matthew J Budoff; Jonathan W Weinsaft; James K Min
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  3     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-14     Completed Date:  2010-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  482-90     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York 10021, USA. tml9001@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / etiology,  radiography
Cellular Phone*
Computers, Handheld*
Coronary Angiography / methods*
Coronary Stenosis / complications,  radiography*
Female
Humans
Male
Middle Aged
Observer Variation
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted / instrumentation*
Reproducibility of Results
Sensitivity and Specificity
Severity of Illness Index
Software
Teleradiology / instrumentation*
Tomography, X-Ray Computed*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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