AIMS: To evaluate non-invasive angiography using dual-source computed tomography (CT) for the determination of the most appropriate therapeutic strategy in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: CT angiography (Dual Source CT, Somatom Definition, Siemens Medical Systems, Forchheim, Germany) was performed in 60 consecutive patients [51 men, median age 64 (57-70) years] scheduled for elective coronary angiography. Both techniques were used to evaluate the presence of CAD, significant stenosis, and the need for revascularization therapy. Sensitivity and specificity for the presence of significant stenosis were: per segment (n = 766) 62% (95% CI 50-72) (64/104) and 79% (95% CI 74-84) (526/662), respectively; per patient (n = 60) 100% (95% CI 91-100) (38/38) and 45% (95% CI 24-68) (10/22), respectively. In therapeutic decision-making based on CT angiography, sensitivity, specificity, positive and negative predictive values for intervention were 97% (95% CI 84-100) (36/37), 48% (95% CI 27-69) (11/23), 75% (95% CI 60-86) (36/48), and 92% (95% CI 60-100) (11/12), respectively. If a revascularization procedure was needed, the CT angiographic data indicated the appropriate modality (percutaneous coronary intervention or coronary artery bypass grafting) in 70% (26/36) of patients. CONCLUSION: Although imaging qualities have improved considerably, CT angiography cannot be used for definitive therapeutic decision-making with regard to revascularization procedures in patients with suspected CAD.
AIMS: To evaluate non-invasive angiography using dual-source computed tomography (CT) for the determination of the most appropriate therapeutic strategy in patients with suspected coronary artery disease (CAD). METHODS AND RESULTS: CT angiography (Dual Source CT, Somatom Definition, Siemens Medical Systems, Forchheim, Germany) was performed in 60 consecutive patients [51 men, median age 64 (57-70) years] scheduled for elective coronary angiography. Both techniques were used to evaluate the presence of CAD, significant stenosis, and the need for revascularization therapy. Sensitivity and specificity for the presence of significant stenosis were: per segment (n = 766) 62% (95% CI 50-72) (64/104) and 79% (95% CI 74-84) (526/662), respectively; per patient (n = 60) 100% (95% CI 91-100) (38/38) and 45% (95% CI 24-68) (10/22), respectively. In therapeutic decision-making based on CT angiography, sensitivity, specificity, positive and negative predictive values for intervention were 97% (95% CI 84-100) (36/37), 48% (95% CI 27-69) (11/23), 75% (95% CI 60-86) (36/48), and 92% (95% CI 60-100) (11/12), respectively. If a revascularization procedure was needed, the CT angiographic data indicated the appropriate modality (percutaneous coronary intervention or coronary artery bypass grafting) in 70% (26/36) of patients. CONCLUSION: Although imaging qualities have improved considerably, CT angiography cannot be used for definitive therapeutic decision-making with regard to revascularization procedures in patients with suspected CAD.
Authors: Si Eun Lee; Kyunghwa Han; Jin Hur; Young Jin Kim; Hye-Jeong Lee; Yoo Jin Hong; Dong Jin Im; Byoung Wook Choi Journal: Eur Radiol Date: 2017-12-08 Impact factor: 5.315