Browse > Article

Diagnostic Accuracy of 64-slice Dual-source Computed Tomography in the Detection of Coronary Artery Stenosis based on Patient Heart Rate and Calcium Scores  

Kim, Eun-Young (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Jin, Gong-Yong (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Han, Young-Min (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Kwak, Hyo-Sung (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Chae, Jei-Keon (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Lee, Sang-Rok (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Kwon, Keun-Sang (Department of Preventive Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
Publication Information
Journal of the Korean Society of Radiology / v.63, no.3, 2010 , pp. 205-215 More about this Journal
Abstract
Purpose: To assess the diagnostic accuracy of dual-source computed tomography (DSCT) in the detection of coronary artery stenosis (CAS) based on patient heart rate and calcium scores. Materials and Methods: This study included 102 patients (46 male, 56 female; mean age $64.1{\pm}10.6$ years; age range 37-92 years) with chest pain and who underwent DSCT as well as invasive coronary angiography. Patients were classified into three groups according to mean heart rate (<70 bpm, 70-90 bpm, and >90 bpm) and also classified in three groups according to Agatston calcium scores (<100, 100-400, and >400). Results: For patients with a mean heart rate < 70 bpm, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 98.5%, 98.2%, 93.6%, 99.1%, and 97.9%, respectively, 99.2%, 99.2%, 97.4%, 99.5%, and 99%, respectively, for 70-90 bpm; and 91.7%, 97.9%, 88.5%, 96.7%, and 95.7%, respectively, for >90 bpm. For calcium scores <100, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 97.2%, 99.0%, 97.0%, 99.3%, and 98.6%, respectively, 98.5%, 99.5%, 96.2%, 99.4%, and 99.0%, respectively, for calcium scores 100-400, and 95.8%, 97.0%, 87.4%, 97.2%, and 95.6%, respectively, for calcium scores >400. Conclusion: DSCT showed a high diagnostic accuracy and negative predictive value, regardless of heart rate and calcium score.
Keywords
Tomography, X-Ray Computed; Coronary Angiography; Coronary Artery Disease;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Leber AW, Johnson T, Becker A, von Ziegler F, Tittus J, Nikolaou K, et al. Diagnostic accuracy of dual-source multi-slice CT coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur Heart J 2007;28:2354-2360   DOI   ScienceOn
2 Achenbach S, Ropers D, Kuettner A, Flohr T, Ohnesorge B, Bruder H, et al. Contrast enhanced coronary artery visualization by dual source computed tomography-initial experience. Eur Radiol 2006;57:331-335   DOI   ScienceOn
3 Leschka S, Alkadhi H, Plass A, Desbiolles L, Grunenfelder J, Marincek B, et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 2005;26:1482-1487   DOI   ScienceOn
4 Nikolaou K, Kenx A, Rist C, Wintersperger BJ, Leber A, Johnson T, et al. Accuracy of 64-MDCT in the diagnosis of ischemic heart disease. AJR Am J Roentgenol 2006;187:111-117   DOI   ScienceOn
5 Brodoefel H, Tsiflikas I, Burgstahler C, Reimann A, Thomas C, Schroeder S, et al. Cardiac dual-source computed tomography: effect of body mass index on image quality and diagnostic accuracy. Invest Radiol 2008;43:712-718   DOI   ScienceOn
6 Johnson TR, Nikolaou K, Wintersperger BJ, Leber AW, von Ziegler F, Rist C, et al. Dual-source CT cardiac imaging: initial experience. Eur Radiol 2006;16:1409-1415   DOI   ScienceOn
7 Achenbach S, Moselewski F, Ropers D, Ferencik M, Hoffmann U, MaeNeill B, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter Multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation 2004;109:14-17
8 Burgstahler C, Reimann A, Drosch T, Heuschmid M, Brodoefel H, Tsiflikas I, et al. Cardiac dual-source computed tomography in patients with severe coronary calcifications and a high prevalence of coronary artery disease. J Cardiovasc Comput Tomogr 2007;1:143-151   DOI   ScienceOn
9 Cademartiri F, Mollet NR, Lemos PA, Saia F, Runza G, Midiri M, et al. Impact of coronary calcium score on diagnostic accuracy for the detection of significant coronary stenosis with multislice computed tomography angiography. Am J Cardiol 2005; 95:1225-1227   DOI   ScienceOn
10 Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the ad hoc committee for grading of coronary artery disease, council on cardiovascular surgery, American Heart Association. Circulation 1975;51(4 Suppl):5-40   DOI
11 Morin RL. Monte carlo simulation in the radiological sciences. Boca Raton, FL: CRC Press, 1988
12 Ong TK, Chin SP, Liew CK, Chan WL, Seyfarth MT, Liew HB, et al. Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: influence of calcification. Am Heart J 2006;151:1323,E1-E6   DOI   ScienceOn
13 Oncel D, Oncel G, Tastan A. Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation. Radiology 2007;245:703-711   DOI   ScienceOn
14 Leber AW, Knez A, Becker A, Becker C, von Ziegler F, Nikolaou K, et al. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol 2004;43:1241-1247   DOI
15 Zhang S, Levin DC, Halpern EJ, Fischman D, Savage M, Walinsky P. Accuracy of MDCT in assessing the degree of stenosis caused by calcified coronary artery plaque. AJR Am J Roentgenol 2008; 191:1676-1683   DOI   ScienceOn
16 Rixe J, Rolf A, Conradi G, Moellmann H, Nef H, Neumann T, et al. Detection of relevant coronary artery disease using dual-source computed tomography in a high probability patient series. Circ J 2009;73:316-322   DOI   ScienceOn
17 Alkadhi H, Scheffel H, Desbiolles L, Gaemperli O, Stolzmann P, Plass A, et al. Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J 2008;29:766-776   DOI   ScienceOn
18 Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64 slice spiral computed tomography. J Am Coll Cardiol 2005;46:552-557   DOI   ScienceOn
19 Leschka S, Wildermuth S, Boehm T, Desbiolles L, Husmann L, Plass A, et al. Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 2006;241:378-385   DOI   ScienceOn
20 Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation 2006;113:1305-1310   DOI   ScienceOn
21 Scheffel H, Alkadhi H, Plass A, Vaschenauer R, Desbiolles L, Gaemperli O, et al. Accuracy of dual source CT coronary angiography: first experience in high pre-test probability population without heart rate control. Eur Radiol 2006;16:2739-2747   DOI   ScienceOn
22 Brodoefel H, Burgstahler C, Tsiflikas I, Reimann A, Schroeder S, Claussen CD, et al. Dual-source CT: effect of heart rate, heart rate variability, and calcification on image quality and diagnostic accuracy. Radiology 2008;247:346-355   DOI   ScienceOn
23 Donnino R, Jacobs J, Doshi JV, Hecht EM, Kim DC, Babb JS, et al. Dual-source versus single-source cardiac CT angiography: comparison of diagnostic image quality. AJR Am J Roentgenol 2009;192: 1051-1056   DOI   ScienceOn
24 Johnson TR, Nikolaou K, Busch S, Leber AW, Becker A, Wintersperger BJ, et al. Diagnostic accuracy of dual-source computed tomography in the diagnosis of coronary artery disease. Invest Radiol 2007;42:684-691   DOI   ScienceOn
25 Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J 2007;28:3042-3050   DOI   ScienceOn
26 Pugliesen F, Mollet NR, Runza G, van Mieghem C, Meijboom WB, Malagutti P, et al. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol 2006;16:575-582   DOI   ScienceOn
27 Fine JJ, Hopkins CB, Ruff N, Newton FC. Comparison of accuracy of 64-slice cardiovascular computed tomography with coronary angiography in patients with suspected coronary artery disease. Am J Cardiol 2006;97:173-174   DOI   ScienceOn
28 Ropers U, Ropers D, Pflederer T, Anders K, Kuettner A, Stilianakis NI, et al. Influence of heart rate on the diagnostic accuracy of dual - source computed tomography coronary angiography. J Am Coll Cardiol 2007;50:2393-2398   DOI   ScienceOn
29 Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ, et al. CT of coronary artery disease. Radiology 2009;253:317-338   DOI   ScienceOn
30 Meijboom WB, Meijs MF, Schuijf JD, Cramer MJ, Mollet NR, van Mieghem CA, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol 2008;52:2135-2144   DOI   ScienceOn