Document Detail


Diagnostic accuracy of second-generation dual-source computed tomography coronary angiography with iterative reconstructions: a real-world experience.
MedLine Citation:
PMID:  22095423     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). MATERIALS AND METHODS: Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70-100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50% and ≥70%, respectively. RESULTS: No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30% (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1%, 93.3%, 53.2% and 99.1% (per segment), 97.5%, 91.2%, 61.4% and 99.6% (per vessel) and 100%, 83%, 71.6% and 100% (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. CONCLUSIONS: CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.
Authors:
E Maffei; C Martini; A Rossi; N Mollet; C Lario; M Castiglione Morelli; A Clemente; G Gentile; T Arcadi; S Seitun; O Catalano; A Aldrovandi; F Cademartiri
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-17
Journal Detail:
Title:  La Radiologia medica     Volume:  -     ISSN:  1826-6983     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0177625     Medline TA:  Radiol Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Unità Cardio-Vascolare Radiologica, Ospedale Giovanni XXIII, Monastier di Treviso (TV), Italy.
Vernacular Title:
Accuratezza diagnostica dell'angiografia coronarica con tomografia computerizzata a doppia sorgente di seconda generazione con ricostruzioni iterative: valutazione nel mondo reale.
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