| Noninvasive coronary angiography by 320-row computed tomography with lower radiation exposure and maintained diagnostic accuracy: comparison of results with cardiac catheterization in a head-to-head pilot investigation. | |
| | |
MedLine Citation:
|
PMID: 19704093 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Noninvasive coronary angiography with the use of multislice computed tomography (CT) scanners is feasible with high sensitivity and negative predictive value; however, the radiation exposure associated with this technique is rather high. We evaluated coronary angiography using whole-heart 320-row CT, which avoids exposure-intensive overscanning and overranging. METHODS AND RESULTS: A total of 30 consecutive patients with suspected coronary artery disease referred for clinically indicated conventional coronary angiography (CCA) were included in this prospective intention-to-diagnose study. CT was performed with the use of up to 320 simultaneous detector rows before same-day CCA, which, together with quantitative analysis, served as the reference standard. The per-patient sensitivity and specificity for CT compared with CCA were 100% (95% confidence interval [CI], 72 to 100) and 94% (95% CI, 73 to 100), respectively. Per-vessel versus per-segment sensitivity and specificity were 89% (95% CI, 62 to 98) and 96% (95% CI, 90 to 99) versus 78% (95% CI, 56 to 91) and 98% (95% CI, 96 to 99), respectively. Interobserver agreement between the 2 readers was significantly better for CCA (97% of 121 coronary arteries) than for CT (90%; P=0.04). Percent diameter stenosis determined with the use of CT showed good correlation with CCA (P<0.001, R=0.81) without significant underestimation or overestimation (-3.1+/-24.4%; P=0.08). Intraindividual comparison of CT with CCA revealed a significantly smaller effective radiation dose (median, 4.2 versus 8.5 mSv; P<0.05) and amount of contrast agent required (median, 80 versus 111 mL; P<0.001) for 320-row CT. The majority of patients (87%) indicated that they would prefer CT over CCA for future diagnostic imaging (P<0.001). CONCLUSIONS: CT with the use of emerging technology has the potential to significantly reduce the radiation dose and amount of contrast agent required compared with CCA while maintaining high diagnostic accuracy. |
| | |
Authors:
|
Marc Dewey; Elke Zimmermann; Florian Deissenrieder; Michael Laule; Hans-Peter D??bel; Peter Schlattmann; Fabian Knebel; Wolfgang Rutsch; Bernd Hamm |
Related Documents
:
|
22538633 - Evaluation of different magnetic resonance imaging techniques for the assessment of act... 22415463 - Myocardial perfusion single-photon emission tomography (spet) and positron emission tom... 8904983 - Evidence of multiple ethanol pools in the brain: an in vivo proton magnetization transf... |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2009-08-24 |
Journal Detail:
|
Title: Circulation Volume: 120 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2009 Sep |
Date Detail:
|
Created Date: 2009-09-09 Completed Date: 2009-10-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 867-75 Citation Subset: AIM; IM |
Affiliation:
|
Charit??, Medical School, Departments of Radiology, Humboldt Universit??t zu Berlin, Freie Universit??t Berlin, Berlin, Germany. dewey@charite.de |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00721851 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Body Burden Contrast Media / administration & dosage Coronary Angiography / methods* Coronary Artery Disease / diagnosis, radiography* Coronary Stenosis / diagnosis Electrocardiography Female Heart Catheterization* Humans Image Processing, Computer-Assisted Male Middle Aged Pilot Projects Prospective Studies Sensitivity and Specificity Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Orthostatic headache without CSF leak.
Next Document: Nitrite therapy after cardiac arrest reduces reactive oxygen species generation, improves cardiac an...