Ivonne Springer1, Marc Dewey. 1. Department of Radiology, Charité, Medical School, Humboldt-Universität zu Berlin, Germany.
Abstract
PURPOSE: Multislice computed tomography (MSCT) is a novel non-invasive test for detection and analysis of coronary artery plaques. A systematic review was conducted of the literature to compare MSCT with IVUS as the reference standard for assessing coronary artery plaques. MATERIALS AND METHODS: We performed a literature search in the online database MEDLINE, which was accessed at http://www.pubmed.gov on 9th April 2008. RESULTS: The search identified 14 studies with 340 patients (mean age 59+/-5 years). The systematic review revealed a sensitivity of MSCT on the lesion level (n=1779 coronary plaques) on the order of 90% (range from 87 to 92%) in comparison to IVUS. Per-segment analysis (n=356) yielded a lower sensitivity of 81-86%. In the per-vessel analysis (n=90), MSCT had a better sensitivity and specificity for the RCA (83-89% and 92-100%) and the LAD (83-87% and 93%) than for the LCX (71-85% and 77-89%), and on the vessel level and the cross-section analysis MSCT was more sensitive for calcified plaques than for non-calcified plaque. It is noteworthy that most studies provide only incomplete data on technical and methodological parameters such as radiation exposure and patient characteristics. CONCLUSION: MSCT is an accurate and reliable test for detection of coronary artery plaques in comparison to IVUS with limitations in regards to the LCX and non-calcified plaques. Studies published thus far are limited by the sample sizes and methodological quality issues.
PURPOSE: Multislice computed tomography (MSCT) is a novel non-invasive test for detection and analysis of coronary artery plaques. A systematic review was conducted of the literature to compare MSCT with IVUS as the reference standard for assessing coronary artery plaques. MATERIALS AND METHODS: We performed a literature search in the online database MEDLINE, which was accessed at http://www.pubmed.gov on 9th April 2008. RESULTS: The search identified 14 studies with 340 patients (mean age 59+/-5 years). The systematic review revealed a sensitivity of MSCT on the lesion level (n=1779 coronary plaques) on the order of 90% (range from 87 to 92%) in comparison to IVUS. Per-segment analysis (n=356) yielded a lower sensitivity of 81-86%. In the per-vessel analysis (n=90), MSCT had a better sensitivity and specificity for the RCA (83-89% and 92-100%) and the LAD (83-87% and 93%) than for the LCX (71-85% and 77-89%), and on the vessel level and the cross-section analysis MSCT was more sensitive for calcified plaques than for non-calcified plaque. It is noteworthy that most studies provide only incomplete data on technical and methodological parameters such as radiation exposure and patient characteristics. CONCLUSION: MSCT is an accurate and reliable test for detection of coronary artery plaques in comparison to IVUS with limitations in regards to the LCX and non-calcified plaques. Studies published thus far are limited by the sample sizes and methodological quality issues.
Authors: Annika Schuhbäck; Mohamed Marwan; Sören Gauss; Gerd Muschiol; Dieter Ropers; Christian Schneider; Michael Lell; Johannes Rixe; Christian Hamm; Werner G Daniel; Stephan Achenbach Journal: Eur Radiol Date: 2012-03-27 Impact factor: 5.315