OBJECTIVES: This study sought to determine the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) to detect or rule out significant coronary artery disease (CAD). BACKGROUND: CTCA is emerging as a noninvasive technique to detect coronary atherosclerosis. METHODS: We conducted a prospective, multicenter, multivendor study involving 360 symptomatic patients with acute and stable anginal syndromes who were between 50 and 70 years of age and were referred for diagnostic conventional coronary angiography (CCA) from September 2004 through June 2006. All patients underwent a nonenhanced calcium scan and a CTCA, which was compared with CCA. No patients or segments were excluded because of impaired image quality attributable to either coronary motion or calcifications. Patient-, vessel-, and segment-based sensitivities and specificities were calculated to detect or rule out significant CAD, defined as >or=50% lumen diameter reduction. RESULTS: The prevalence among patients of having at least 1 significant stenosis was 68%. In a patient-based analysis, the sensitivity for detecting patients with significant CAD was 99% (95% confidence interval [CI]: 98% to 100%), specificity was 64% (95% CI: 55% to 73%), positive predictive value was 86% (95% CI: 82% to 90%), and negative predictive value was 97% (95% CI: 94% to 100%). In a segment-based analysis, the sensitivity was 88% (95% CI: 85% to 91%), specificity was 90% (95% CI: 89% to 92%), positive predictive value was 47% (95% CI: 44% to 51%), and negative predictive value was 99% (95% CI: 98% to 99%). CONCLUSIONS: Among patients in whom a decision had already been made to obtain CCA, 64-slice CTCA was reliable for ruling out significant CAD in patients with stable and unstable anginal syndromes. A positive 64-slice CTCA scan often overestimates the severity of atherosclerotic obstructions and requires further testing to guide patient management.
OBJECTIVES: This study sought to determine the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) to detect or rule out significant coronary artery disease (CAD). BACKGROUND: CTCA is emerging as a noninvasive technique to detect coronary atherosclerosis. METHODS: We conducted a prospective, multicenter, multivendor study involving 360 symptomatic patients with acute and stable anginal syndromes who were between 50 and 70 years of age and were referred for diagnostic conventional coronary angiography (CCA) from September 2004 through June 2006. All patients underwent a nonenhanced calcium scan and a CTCA, which was compared with CCA. No patients or segments were excluded because of impaired image quality attributable to either coronary motion or calcifications. Patient-, vessel-, and segment-based sensitivities and specificities were calculated to detect or rule out significant CAD, defined as >or=50% lumen diameter reduction. RESULTS: The prevalence among patients of having at least 1 significant stenosis was 68%. In a patient-based analysis, the sensitivity for detecting patients with significant CAD was 99% (95% confidence interval [CI]: 98% to 100%), specificity was 64% (95% CI: 55% to 73%), positive predictive value was 86% (95% CI: 82% to 90%), and negative predictive value was 97% (95% CI: 94% to 100%). In a segment-based analysis, the sensitivity was 88% (95% CI: 85% to 91%), specificity was 90% (95% CI: 89% to 92%), positive predictive value was 47% (95% CI: 44% to 51%), and negative predictive value was 99% (95% CI: 98% to 99%). CONCLUSIONS: Among patients in whom a decision had already been made to obtain CCA, 64-slice CTCA was reliable for ruling out significant CAD in patients with stable and unstable anginal syndromes. A positive 64-slice CTCA scan often overestimates the severity of atherosclerotic obstructions and requires further testing to guide patient management.
Authors: Rine Nakanishi; Wendy S Post; Kazuhiro Osawa; Eranthi Jayawardena; Michael Kim; Nasim Sheidaee; Negin Nezarat; Sina Rahmani; Nicholas Kim; Nicolai Hathiramani; Shriraj Susarla; Frank Palella; Mallory Witt; Michael J Blaha; Todd T Brown; Lawrence Kingsley; Sabina A Haberlen; Christopher Dailing; Matthew J Budoff Journal: Coron Artery Dis Date: 2018-01 Impact factor: 1.439
Authors: E Maffei; S Seitun; C Martini; A Aldrovandi; T Arcadi; A Clemente; G Messalli; R Malagò; A Weustink; N Mollet; K Nieman; D Ardissino; P de Feyter; G Krestin; F Cademartiri Journal: Radiol Med Date: 2010-10-06 Impact factor: 3.469
Authors: E di Cesare; I Carbone; A Carriero; M Centonze; F De Cobelli; R De Rosa; P Di Renzi; A Esposito; R Faletti; R Fattori; M Francone; A Giovagnoni; L La Grutta; G Ligabue; L Lovato; R Marano; M Midiri; L Natale; A Romagnoli; V Russo; F Sardanelli; F Cademartiri Journal: Radiol Med Date: 2012-04-01 Impact factor: 3.469
Authors: Robert Roehle; Viktoria Wieske; Georg M Schuetz; Pascal Gueret; Daniele Andreini; Willem Bob Meijboom; Gianluca Pontone; Mario Garcia; Hatem Alkadhi; Lily Honoris; Jörg Hausleiter; Nuno Bettencourt; Elke Zimmermann; Sebastian Leschka; Bernhard Gerber; Carlos Rochitte; U Joseph Schoepf; Abbas Arjmand Shabestari; Bjarne Nørgaard; Akira Sato; Juhani Knuuti; Matthijs F L Meijs; Harald Brodoefel; Shona M M Jenkins; Kristian Altern Øvrehus; Axel Cosmus Pyndt Diederichsen; Ashraf Hamdan; Bjørn Arild Halvorsen; Vladimir Mendoza Rodriguez; Yung Liang Wan; Johannes Rixe; Mehraj Sheikh; Christoph Langer; Said Ghostine; Eugenio Martuscelli; Hiroyuki Niinuma; Arthur Scholte; Konstantin Nikolaou; Geir Ulimoen; Zhaoqi Zhang; Hans Mickley; Koen Nieman; Philipp A Kaufmann; Ronny Ralf Buechel; Bernhard A Herzog; Melvin Clouse; David A Halon; Jonathan Leipsic; David Bush; Reda Jakamy; Kai Sun; Lin Yang; Thorsten Johnson; Jean-Pierre Laissy; Roy Marcus; Simone Muraglia; Jean-Claude Tardif; Benjamin Chow; Narinder Paul; David Maintz; John Hoe; Albert de Roos; Robert Haase; Michael Laule; Peter Schlattmann; Marc Dewey Journal: Eur Radiol Date: 2018-03-19 Impact factor: 5.315
Authors: Arthur E Stillman; Matthijs Oudkerk; David A Bluemke; Menko Jan de Boer; Jens Bremerich; Ernest V Garcia; Matthias Gutberlet; Pim van der Harst; W Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond Y Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Riemer H J A Slart; Vinod Thourani; Rozemarijn Vliegenthart; Bernd J Wintersperger Journal: Int J Cardiovasc Imaging Date: 2018-03-19 Impact factor: 2.357