Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience.

Abstract

OBJECTIVES:

The objective was to prospectively investigate the diagnostic accuracy of high-pitch (HP) dual-source computed tomography coronary angiography (CTCA) compared with catheter coronary angiography (CCA) for the diagnosis of significant coronary stenoses.

METHODS:

Thirty-five patients (seven women; mean age 62 ± 8 years) underwent both CTCA and CCA. CTCA was performed with a second-generation dual-source CT system permitting data acquisition at an HP of 3.4. Patients with heart rates >60 bpm were excluded from study enrolment. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a four-point scale (1: excellent to 4: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). CCA served as the standard of reference. Radiation dose values were calculated using the dose-length product.

RESULTS:

Diagnostic image quality was found in 99% of all segments (455/459). Non-diagnostic image quality occurred in a single patient with a sudden increase in heart rate immediately before and during CTCA. Taking segments with non-evaluative image quality as positive for disease, the sensitivity, specificity and positive and negative predictive values were 94, 96, 80 and 99% per segment and 100, 91, 88 and 100% per patient. The effective radiation dose was on average 0.9 ± 0.1 mSv.

CONCLUSION:

In patients with heart rates ≤60 bpm, CTCA using the HP mode of the dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at sub-milli-Sievert doses.

• Authors: Sebastian Leschka, Paul Stolzmann, Lotus Desbiolles, Stephan Baumueller, Robert Goetti, Thomas Schertler, Hans Scheffel, Andre Plass, Volkmar Falk, Gudrun Feuchtner, Borut Marincek, Hatem Alkadhi
• Journal: European radiology (Eur Radiol) Vol. 19 Issue 12 Pg. 2896-903 (Dec 2009) ISSN: 1432-1084 [Electronic] Germany
• PMID: 19760229 (Publication Type: Journal Article)

Topics

• Aged
• Coronary Angiography (methods)
• Coronary Stenosis (diagnostic imaging)
• Female
• Humans
• Male
• Middle Aged
• Pilot Projects
• Radiographic Image Enhancement (methods)
• Radiography, Dual-Energy Scanned Projection (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)