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Accuracy of quantitative coronary angiography with computed tomography and its dependency on plaque composition: Plaque composition and accuracy of cardiac CT


Husmann, L; Gaemperli, O; Schepis, T; Scheffel, H; Valenta, I; Hoefflinghaus, T; Stolzmann, P; Desbiolles, L; Herzog, B A; Leschka, S; Marincek, B; Alkadhi, H; Kaufmann, P A (2008). Accuracy of quantitative coronary angiography with computed tomography and its dependency on plaque composition: Plaque composition and accuracy of cardiac CT. International Journal of Cardiovascular Imaging, 24(8):895-904.

Abstract

Objective: To determine the impact of plaque composition on accuracy of quantitative 64-slice computed tomography coronary angiography (CTCA). Methods: The institutional review board approved this study; written informed consent was obtained from all patients. One hundred consecutive patients (42 women, mean age 64.6 +/- 9.4 years, age range 39-87 years) underwent CTCA and invasive quantitative coronary angiography (QCA) to determine (a) the diagnostic accuracy of CTCA for the detection of significant stenosis (diameter reduction of >/=50%), and (b) the accuracy of stenosis grading. In CTCA stenosis severity was graded in 10% steps and evaluated separately for calcified and non-calcified coronary lesions using Pearson-linear-regression analysis, Bland/Altman-analysis (BA), and Mann-Whitney-U-test. Results: In 60/100 patients 139 significant coronary artery stenoses were identified with QCA. On a per-segment analysis, sensitivity of CTCA was 75.5%, and specificity was 96.6% (positive predictive value: 72.9%, negative predictive value: 97.0%). Quantification of stenosis grading correlated moderately between methods (r = 0.60; P < 0.001), with an overestimation by CTCA of 5.5% (BA limits-of-agreement -29 to 39%). BA limits-of-agreement were greater in calcified lesions (-29.2 to 45.6%; mean error 8.2%) than in non-calcified lesions (-25.9 to 30.2%; mean error 2.2%) and differed significantly (P < 0.05). Conclusions: Diagnostic accuracy of CTCA is high, however agreement for quantitative lesion severity assessment between CTCA and QCA is moderate for calcified but superior for non-calcified lesions.

Objective: To determine the impact of plaque composition on accuracy of quantitative 64-slice computed tomography coronary angiography (CTCA). Methods: The institutional review board approved this study; written informed consent was obtained from all patients. One hundred consecutive patients (42 women, mean age 64.6 +/- 9.4 years, age range 39-87 years) underwent CTCA and invasive quantitative coronary angiography (QCA) to determine (a) the diagnostic accuracy of CTCA for the detection of significant stenosis (diameter reduction of >/=50%), and (b) the accuracy of stenosis grading. In CTCA stenosis severity was graded in 10% steps and evaluated separately for calcified and non-calcified coronary lesions using Pearson-linear-regression analysis, Bland/Altman-analysis (BA), and Mann-Whitney-U-test. Results: In 60/100 patients 139 significant coronary artery stenoses were identified with QCA. On a per-segment analysis, sensitivity of CTCA was 75.5%, and specificity was 96.6% (positive predictive value: 72.9%, negative predictive value: 97.0%). Quantification of stenosis grading correlated moderately between methods (r = 0.60; P < 0.001), with an overestimation by CTCA of 5.5% (BA limits-of-agreement -29 to 39%). BA limits-of-agreement were greater in calcified lesions (-29.2 to 45.6%; mean error 8.2%) than in non-calcified lesions (-25.9 to 30.2%; mean error 2.2%) and differed significantly (P < 0.05). Conclusions: Diagnostic accuracy of CTCA is high, however agreement for quantitative lesion severity assessment between CTCA and QCA is moderate for calcified but superior for non-calcified lesions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:June 2008
Deposited On:26 Sep 2008 09:12
Last Modified:13 Sep 2016 07:29
Publisher:Springer
ISSN:1569-5794
Publisher DOI:10.1007/s10554-008-9327-z
PubMed ID:18563625
Permanent URL: http://doi.org/10.5167/uzh-3591

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