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Accuracy of dual-source computed tomography coronary angiography: evaluation with a standardised protocol for cardiac surgeons


Plass, A; Azemaj, N; Scheffel, H; Desbiolles, L; Alkadhi, H; Genoni, M; Falk, V; Grünenfelder, J (2009). Accuracy of dual-source computed tomography coronary angiography: evaluation with a standardised protocol for cardiac surgeons. European Journal of Cardio-Thoracic Surgery, 36(6):1011-1017.

Abstract

Background: This study assesses the accuracy of the new dual-source computed tomography (DSCT) for detection of coronary artery disease (CAD) compared with invasive coronary angiography (ICA) with a specifically designed data presentation protocol for cardiac surgeons. Methods: Forty patients (30 males/10 females) underwent ICA and DSCT. Best-quality images were prepared by radiologists. Evaluation of 12 segments of significant coronary stenosis was done by two cardiac surgeons with a data presentation protocol including different coronary views in two-/three-dimensional (2D/3D) images. No beta-blockers were administered prior to DSCT. Results: ICA revealed CAD in 21 patients and valvular disease but no CAD in 19 patients. In DSCT, 20/21 patients were diagnosed with CAD (at least one significant stenosis per patient). In 11/21 patients, all 12 segments were assessed correctly; in 7/21 patients one segment and in 3/21 patients two segments were evaluated incorrectly. Of all 21 patients with CAD, 239/252 segments (95%) were correctly evaluated. In 18/19 patients without CAD, DSCT correctly ruled-out the ICA results in 226/228 segments (99%). In total, 465/480 segments were correctly assessed (97%). Of 480 segments, only six were considered not assessable. DSCT assessments of the segments showed a sensitivity of 91%, specificity of 99%, a positive predictive value of 92% and a negative predictive value of 99%. Conclusions: The accuracy of DSCT coronary angiography especially for exclusion of CAD is promising. The introduced data presentation protocol allows for the independent evaluation by cardiac surgeons after pre-arrangement from the radiologists.

Abstract

Background: This study assesses the accuracy of the new dual-source computed tomography (DSCT) for detection of coronary artery disease (CAD) compared with invasive coronary angiography (ICA) with a specifically designed data presentation protocol for cardiac surgeons. Methods: Forty patients (30 males/10 females) underwent ICA and DSCT. Best-quality images were prepared by radiologists. Evaluation of 12 segments of significant coronary stenosis was done by two cardiac surgeons with a data presentation protocol including different coronary views in two-/three-dimensional (2D/3D) images. No beta-blockers were administered prior to DSCT. Results: ICA revealed CAD in 21 patients and valvular disease but no CAD in 19 patients. In DSCT, 20/21 patients were diagnosed with CAD (at least one significant stenosis per patient). In 11/21 patients, all 12 segments were assessed correctly; in 7/21 patients one segment and in 3/21 patients two segments were evaluated incorrectly. Of all 21 patients with CAD, 239/252 segments (95%) were correctly evaluated. In 18/19 patients without CAD, DSCT correctly ruled-out the ICA results in 226/228 segments (99%). In total, 465/480 segments were correctly assessed (97%). Of 480 segments, only six were considered not assessable. DSCT assessments of the segments showed a sensitivity of 91%, specificity of 99%, a positive predictive value of 92% and a negative predictive value of 99%. Conclusions: The accuracy of DSCT coronary angiography especially for exclusion of CAD is promising. The introduced data presentation protocol allows for the independent evaluation by cardiac surgeons after pre-arrangement from the radiologists.

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11 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:24 Aug 2009 10:34
Last Modified:21 Nov 2017 14:17
Publisher:Elsevier
ISSN:1010-7940
Publisher DOI:https://doi.org/10.1016/j.ejcts.2009.06.027
PubMed ID:19646889

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