Gianluca De Rubeis1, Adriane E Napp2, Peter Schlattmann3, Jacob Geleijns4, Michael Laule5, Henryk Dreger5, Klaus Kofoed6,7, Mathias Sørgaard7, Thomas Engstrøm7, Hans Henrik Tilsted7, Alberto Boi8, Michele Porcu9, Stefano Cossa10, José F Rodríguez-Palomares11, Filipa Xavier Valente11, Albert Roque12, Gudrun Feuchtner13, Fabian Plank14, Cyril Štěchovský15, Theodor Adla16, Stephen Schroeder17, Thomas Zelesny18, Matthias Gutberlet19, Michael Woinke20, Mihály Károlyi21, Júlia Karády22, Patrick Donnelly22, Peter Ball23, Jonathan Dodd24, Mark Hensey25, Massimo Mancone26, Andrea Ceccacci26, Marina Berzina27, Ligita Zvaigzne28, Gintare Sakalyte29, Algidas Basevičius30, Małgorzata Ilnicka-Suckiel31, Donata Kuśmierz32, Rita Faria33, Vasco Gama-Ribeiro33, Imre Benedek34, Teodora Benedek34, Filip Adjić35, Milenko Čanković36, Colin Berry37, Christian Delles37, Erica Thwaite38, Gershan Davis39, Juhani Knuuti40, Mikko Pietilä41, Cezary Kepka42, Mariusz Kruk43, Radosav Vidakovic44, Aleksandar N Neskovic44, Iñigo Lecumberri45, Ignacio Diez Gonzales46, Balazs Ruzsics47, Mike Fisher47, Marc Dewey2, Marco Francone48,49. 1. Department of Radiology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. 2. Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. 3. Department of Statistics, Informatics and Data Science, Jena University Hospital, Jena, Germany. 4. Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. 5. Department of Cardiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. 6. Department of Radiology, Rigshospitalet Region Hovedstaden, Rigshospitalet 9, 2100, Copenhagen, Denmark. 7. Department of Cardiology, Rigshospitalet Region Hovedstaden, Rigshospitalet 9, 2100, Copenhagen, Denmark. 8. Department of Cardiology, Azienda Ospedaliera Brotzu, Cagliari, CA, Italy. 9. Department of Radiology, Azienda Ospedaliera Universitaria di Cagliari, AOU di Cagliari - Polo di Monserrato, 09042, Monserrato, CA, Italy. 10. Department of Radiology, Azienda Ospedaliera Brotzu, Cagliari, CA, Italy. 11. Department of Cardiology, Hospital Universitari Vall d´Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de Vall d'Hebron 119, 08035, Barcelona, Spain. 12. Department of Radiology, Hospital Universitari Vall d´Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Passeig de Vall d'Hebron 119, 08035, Barcelona, Spain. 13. Department of Radiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. 14. Department of Cardiology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria. 15. Department of Cardiology, University Hospital Motol, Vuvalu 84, 150 06, Prague 5, Czech Republic. 16. Department of Radiology, University Hospital Motol, Vuvalu 84, 150 06, Prague 5, Czech Republic. 17. Department of Cardiology, ALB FILS KLINIKEN GmbH, Eichertstrasse 3, 73035, Goeppingen, Germany. 18. Department of Radiology, ALB FILS KLINIKEN GmbH, Eichertstrasse 3, 73035, Goeppingen, Germany. 19. Department of Radiology, University of Leipzig Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany. 20. Department of Cardiology, University of Leipzig Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany. 21. MTA-SE Cardiovascular Imaging Center, Heart and Vascular Center, Semmelweis University, Varosmajor u 68, Budapest, 1122, Hungary. 22. Department of Cardiology, Southeastern Health and Social Care Trust, Upper Newtownards Road Ulster, Belfast, BT16 1RH, UK. 23. Department of Radiology, Southeastern Health and Social Care Trust, Upper Newtownards Road Ulster, Belfast, BT16 1RH, UK. 24. Department of Radiology, St. Vincent's University Hospital and National University of Ireland, Belfield Campus, 4, Dublin, Ireland. 25. Department of Cardiology, St. Vincent's University Hospital, Belfield Campus, 4, Dublin, Ireland. 26. Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. 27. Department of Cardiology, Paul Stradins Clinical University Hospital, Pilsoņu Street 13, Riga, 1002, Latvia. 28. Department of Radiology, Paul Stradins Clinical University Hospital, Pilsoņu Street 13, Riga, 1002, Latvia. 29. Department of Cardiology, Lithuanian University of Health Sciences, Eivelniu 2, 50009, Kaunas, Lithuania. 30. Department of Radiology, Lithuanian University of Health Sciences, Eivelniu 2, 50009, Kaunas, Lithuania. 31. Department of Cardiology, Wojewodzki Szpital Specjalistyczny We Wroclawiu, Ul. Henryka Michala Kamienskiego, 51124, Wroclaw, Poland. 32. Department of Radiology, Wojewodzki Szpital Specjalistyczny We Wroclawiu, Ul. Henryka Michala Kamienskiego, 51124, Wroclaw, Poland. 33. Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia, Rua Conceicao Fernandes, 4434 502, Vila Nova de Gaia, Portugal. 34. Department of Cardiology, Cardio Med Medical Center, 22 decembrie 1989, 540156, Targu-Mures, Romania. 35. Radiology Department Imaging Center, Institute of Cardiovascular Diseases of Vojvodina, Put dr Goldmana 4, Sremska Kamenica, Novi Sad, 212014, Serbia. 36. Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Put dr Goldmana 4, Sremska Kamenica, Novi Sad, 212014, Serbia. 37. Institute of Cardiovascular and Medical Sciences, University of Glasgow, University Place 126, Glasgow, G12 8TA, UK. 38. Department of Radiology, Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL, UK. 39. Department of Cardiology, Aintree University Hospital, Longmoor Lane, Liverpool, L9 7AL, UK. 40. Turku PET Centre, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20120, Turku, Finland. 41. Heart Centre, Turku University Hospital, Kiinamyllynkatu 4-8, FI 20120, Turku, Finland. 42. Department of Radiology, The Institute of Cardiology in Warsaw, Ul. Alpejska 42, 04-628, Warsaw, Poland. 43. Department of Cardiology, The Institute of Cardiology in Warsaw, Ul. Alpejska 42, 04-628, Warsaw, Poland. 44. Department of Cardiology, Clinical Hospital Center Zemun, Vukova 9, Belgrade-Zemun, 11080, Serbia. 45. Department of Radiology, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain. 46. Department of Cardiology, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain. 47. Department of Cardiology, Royal Liverpool and Broadgreen University Hospitals, Prescot Street, Liverpool, L7 8XP, UK. 48. Department of Radiology, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. marco.francone@uniroma1.it. 49. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, V.le Regina Elena, 324 00161, Rome, Italy. marco.francone@uniroma1.it.
Abstract
OBJECTIVE: To implement detailed EU cardiac computed tomography angiography (CCTA) quality criteria in the multicentre DISCHARGE trial (FP72007-2013, EC-GA 603266), we reviewed image quality and adherence to CCTA protocol and to the recommendations of invasive coronary angiography (ICA) in a pilot study. MATERIALS AND METHODS: From every clinical centre, imaging datasets of three patients per arm were assessed for adherence to the inclusion/exclusion criteria of the pilot study, predefined standards for the CCTA protocol and ICA recommendations, image quality and non-diagnostic (NDX) rate. These parameters were compared via multinomial regression and ANOVA. If a site did not reach the minimum quality level, additional datasets had to be sent before entering into the final accepted database (FADB). RESULTS: We analysed 226 cases (150 CCTA/76 ICA). The inclusion/exclusion criteria were not met by 6 of the 226 (2.7%) datasets. The predefined standard was not met by 13 of 76 ICA datasets (17.1%). This percentage decreased between the initial CCTA database and the FADB (multinomial regression, 53 of 70 vs 17 of 75 [76%] vs [23%]). The signal-to-noise ratio and contrast-to-noise ratio of the FADB did not improve significantly (ANOVA, p = 0.20; p = 0.09). The CTA NDX rate was reduced, but not significantly (initial CCTA database 15 of 70 [21.4%]) and FADB 9 of 75 [12%]; p = 0.13). CONCLUSION: We were able to increase conformity to the inclusion/exclusion criteria and CCTA protocol, improve image quality and decrease the CCTA NDX rate by implementing EU CCTA quality criteria and ICA recommendations. KEY POINTS: • Failure to meet protocol adherence in cardiac CTA was high in the pilot study (77.6%). • Image quality varies between sites and can be improved by feedback given by the core lab. • Conformance with new EU cardiac CT quality criteria might render cardiac CTA findings more consistent and comparable.
OBJECTIVE: To implement detailed EU cardiac computed tomography angiography (CCTA) quality criteria in the multicentre DISCHARGE trial (FP72007-2013, EC-GA 603266), we reviewed image quality and adherence to CCTA protocol and to the recommendations of invasive coronary angiography (ICA) in a pilot study. MATERIALS AND METHODS: From every clinical centre, imaging datasets of three patients per arm were assessed for adherence to the inclusion/exclusion criteria of the pilot study, predefined standards for the CCTA protocol and ICA recommendations, image quality and non-diagnostic (NDX) rate. These parameters were compared via multinomial regression and ANOVA. If a site did not reach the minimum quality level, additional datasets had to be sent before entering into the final accepted database (FADB). RESULTS: We analysed 226 cases (150 CCTA/76 ICA). The inclusion/exclusion criteria were not met by 6 of the 226 (2.7%) datasets. The predefined standard was not met by 13 of 76 ICA datasets (17.1%). This percentage decreased between the initial CCTA database and the FADB (multinomial regression, 53 of 70 vs 17 of 75 [76%] vs [23%]). The signal-to-noise ratio and contrast-to-noise ratio of the FADB did not improve significantly (ANOVA, p = 0.20; p = 0.09). The CTA NDX rate was reduced, but not significantly (initial CCTA database 15 of 70 [21.4%]) and FADB 9 of 75 [12%]; p = 0.13). CONCLUSION: We were able to increase conformity to the inclusion/exclusion criteria and CCTA protocol, improve image quality and decrease the CCTA NDX rate by implementing EU CCTA quality criteria and ICA recommendations. KEY POINTS: • Failure to meet protocol adherence in cardiac CTA was high in the pilot study (77.6%). • Image quality varies between sites and can be improved by feedback given by the core lab. • Conformance with new EU cardiac CT quality criteria might render cardiac CTA findings more consistent and comparable.
Authors: P J Scanlon; D P Faxon; A M Audet; B Carabello; G J Dehmer; K A Eagle; R D Legako; D F Leon; J A Murray; S E Nissen; C J Pepine; R M Watson; J L Ritchie; R J Gibbons; M D Cheitlin; T J Gardner; A Garson; R O Russell; T J Ryan; S C Smith Journal: J Am Coll Cardiol Date: 1999-05 Impact factor: 24.094
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Authors: Jonathon Leipsic; Troy M Labounty; Brett Heilbron; James K Min; G B John Mancini; Fay Y Lin; Carolyn Taylor; Allison Dunning; James P Earls Journal: AJR Am J Roentgenol Date: 2010-09 Impact factor: 3.959
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Authors: Michael J Wolk; Steven R Bailey; John U Doherty; Pamela S Douglas; Robert C Hendel; Christopher M Kramer; James K Min; Manesh R Patel; Lisa Rosenbaum; Leslee J Shaw; Raymond F Stainback; Joseph M Allen; Ralph G Brindis; Christopher M Kramer; Leslee J Shaw; Manuel D Cerqueira; Jersey Chen; Larry S Dean; Reza Fazel; W Gregory Hundley; Dipti Itchhaporia; Paul Kligfield; Richard Lockwood; Joseph Edward Marine; Robert Benjamin McCully; Joseph V Messer; Patrick T O'Gara; Richard J Shemin; L Samuel Wann; John B Wong; Manesh R Patel; Christopher M Kramer; Steven R Bailey; Alan S Brown; John U Doherty; Pamela S Douglas; Robert C Hendel; Bruce D Lindsay; James K Min; Leslee J Shaw; Raymond F Stainback; L Samuel Wann; Michael J Wolk; Joseph M Allen Journal: J Card Fail Date: 2013-12-16 Impact factor: 5.712
Authors: Paul Stolzmann; Hans Scheffel; Thomas Schertler; Thomas Frauenfelder; Sebastian Leschka; Lars Husmann; Thomas G Flohr; Borut Marincek; Philipp A Kaufmann; Hatem Alkadhi Journal: Eur Radiol Date: 2007-10-02 Impact factor: 5.315