Open AccessDiagnostic accuracy of prospective ECG gated coronary computed tomography on a 256 slices scanner: Daily practice experience
Author(s) -
Ahmed M. Fareed,
J. Pernès,
Maher Hakim,
J C Gaux,
Ramon Labbé,
Gérard Haquin,
Mario Auguste,
Mohamed Oraby,
Gamila M. Nasr,
Fathi A. Maklady,
Patrick Dupouy
Publication year - 2014
Publication title -
the egyptian heart journal /the egyptian heart journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.212
H-Index - 9
eISSN - 2090-911X
pISSN - 1110-2608
DOI - 10.1016/j.ehj.2013.12.018
Subject(s) - medicine , stenosis , coronary artery disease , coronary angiography , radiology , diagnostic accuracy , prospective cohort study , scanner , coronary arteries , lumen (anatomy) , computed tomography , computed tomography angiography , nuclear medicine , cardiology , artery , physics , myocardial infarction , optics
To determine the accuracy of prospective ECG-gated computed tomography coronary angiography (CTCA) using 256-slice scanner for detecting significant coronary artery disease (CAD) and to quantitatively estimate lumen narrowing with CTCA in comparison to invasive coronary angiography (ICA).Methods: This study included 109 consecutive patients who had ICA on the basis of a previous CTCA (within 60 days) for clinical suspicious of CAD. All CTCA scans were performed with a 256-slice scanner using prospective ECG-gated image acquisition. The presence of stenosis ⩾50%, measured by QCA for ICA and Visual assessment for CTCA, was considered significant stenosis.Results: Obstructive CAD was present in 73.4% of patients. On patient-based analysis, the sensitivity of CTCA was 98%, specificity 83%, PPV 94% and NPV 92%. For segment-based analysis, a total of 1584 segments were analyzed with a sensitivity of 89%, specificity 98%, PPV 85% and NPV 99%. High correlation was observed between degrees of luminal stenosis assessed by CTCA in comparison to QCA in all segments (r2 = 0.961). There was high agreement between observers regarding the presence of significant luminal stenosis (k = 0.78) and good correlation for percentage of luminal stenosis (r = 0.68, p < 0.001) between both readers.Conclusions: In a highly prevalence diseased population, prospective ECG-gated CTCA using 256-slice scanner is highly accurate for detection and quantification of the degree of coronary luminal stenosis in comparison to ICA