Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control
The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) wit...
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| Veröffentlicht in: | European radiology 2006-12, Vol.16 (12), p.2739-2747 |
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| creator | Scheffel, Hans Alkadhi, Hatem Plass, André Vachenauer, Robert Desbiolles, Lotus Gaemperli, Oliver Schepis, Tiziano Frauenfelder, Thomas Schertler, Thomas Husmann, Lars Grunenfelder, Jürg Genoni, Michele Kaufmann, Philipp A Marincek, Borut Leschka, Sebastian |
| description | The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14+/-9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter > or =1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3+/-3.9 kg/m2 (range 22.4-36.3 kg/m2), mean heart rate during CT was 70.3+/-14.2 bpm (range 47-102 bpm), and mean Agatston score was 821+/-904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68+/-0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control. |
| doi_str_mv | 10.1007/s00330-006-0474-0 |
| format | Article |
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Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14+/-9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter > or =1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3+/-3.9 kg/m2 (range 22.4-36.3 kg/m2), mean heart rate during CT was 70.3+/-14.2 bpm (range 47-102 bpm), and mean Agatston score was 821+/-904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68+/-0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-006-0474-0</identifier><identifier>PMID: 17031451</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Accuracy ; Adult ; Aged ; Aged, 80 and over ; Angiography ; Body mass index ; Body size ; Calcinosis - diagnostic imaging ; Cardiac ; Cardiovascular disease ; Chi-Square Distribution ; Computed tomography ; Coronary Angiography - methods ; Coronary artery disease ; Coronary Disease - diagnostic imaging ; Diagnostic systems ; Disease control ; Female ; Heart diseases ; Heart rate ; Heart Rate - physiology ; Humans ; Image quality ; Male ; Medical imaging ; Middle Aged ; Population studies ; Predictive Value of Tests ; Ratings ; Risk Factors ; Segments ; Sensitivity analysis ; Sensitivity and Specificity ; Tomography, X-Ray Computed</subject><ispartof>European radiology, 2006-12, Vol.16 (12), p.2739-2747</ispartof><rights>Springer-Verlag 2006.</rights><rights>Springer-Verlag 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-2643cb3bb90a56210c48119ffe0234320f36bbccdcd7c0fe74521bb318abc1913</citedby><cites>FETCH-LOGICAL-c491t-2643cb3bb90a56210c48119ffe0234320f36bbccdcd7c0fe74521bb318abc1913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,886,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17031451$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scheffel, Hans</creatorcontrib><creatorcontrib>Alkadhi, Hatem</creatorcontrib><creatorcontrib>Plass, André</creatorcontrib><creatorcontrib>Vachenauer, Robert</creatorcontrib><creatorcontrib>Desbiolles, Lotus</creatorcontrib><creatorcontrib>Gaemperli, Oliver</creatorcontrib><creatorcontrib>Schepis, Tiziano</creatorcontrib><creatorcontrib>Frauenfelder, Thomas</creatorcontrib><creatorcontrib>Schertler, Thomas</creatorcontrib><creatorcontrib>Husmann, Lars</creatorcontrib><creatorcontrib>Grunenfelder, Jürg</creatorcontrib><creatorcontrib>Genoni, Michele</creatorcontrib><creatorcontrib>Kaufmann, Philipp A</creatorcontrib><creatorcontrib>Marincek, Borut</creatorcontrib><creatorcontrib>Leschka, Sebastian</creatorcontrib><title>Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><description>The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14+/-9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter > or =1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3+/-3.9 kg/m2 (range 22.4-36.3 kg/m2), mean heart rate during CT was 70.3+/-14.2 bpm (range 47-102 bpm), and mean Agatston score was 821+/-904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68+/-0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Cardiac</subject><subject>Cardiovascular disease</subject><subject>Chi-Square Distribution</subject><subject>Computed tomography</subject><subject>Coronary Angiography - methods</subject><subject>Coronary artery disease</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Diagnostic systems</subject><subject>Disease control</subject><subject>Female</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Image quality</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Population studies</subject><subject>Predictive Value of Tests</subject><subject>Ratings</subject><subject>Risk Factors</subject><subject>Segments</subject><subject>Sensitivity analysis</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdUU1v1DAUtBAVXRZ-ABdkCYmb6XuxEycckKpVC0iVeilny_Y6G1fZONgOsH-A311Xu-Kjp3d4M_PezBDyBuEDAsiLBMA5MICGgZCCwTOyQsErhtCK52QFHW-Z7DpxTl6mdA8AHQr5gpyjBI6ixhX5fWntErU90NDT7aJHlsISraObO2pDDJOOB6qnnQ-7qOfh8JFe-5gydb9mF72bCtJPVNPB7wY6R8eyK9s5BqONH30-0DnMy6izDxP96fMQlkwHp2OmUWdXbkw5hvEVOev1mNzr01yTb9dXd5sv7Ob289fN5Q2zosPMqkZwa7gxHei6qRCsaBG7vndQ8WIcet4YY-3WbqWF3klRV2gMx1Ybix3yNfl01J0Xs3db68p1Pao5-n0xqoL26v_N5Ae1Cz9USayuRV0E3p8EYvi-FK9q75N146gnF5akmhZbUZXg1-TdE-B9CXYq5hTHSgqQvHy8JnhE2RhSiq7_8wqCeuxYHTtWpWP12LGCwnn7r4e_jFOp_AG-I6Us</recordid><startdate>20061201</startdate><enddate>20061201</enddate><creator>Scheffel, Hans</creator><creator>Alkadhi, Hatem</creator><creator>Plass, André</creator><creator>Vachenauer, Robert</creator><creator>Desbiolles, Lotus</creator><creator>Gaemperli, Oliver</creator><creator>Schepis, Tiziano</creator><creator>Frauenfelder, Thomas</creator><creator>Schertler, Thomas</creator><creator>Husmann, Lars</creator><creator>Grunenfelder, Jürg</creator><creator>Genoni, Michele</creator><creator>Kaufmann, Philipp A</creator><creator>Marincek, Borut</creator><creator>Leschka, Sebastian</creator><general>Springer Nature B.V</general><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20061201</creationdate><title>Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control</title><author>Scheffel, Hans ; Alkadhi, Hatem ; Plass, André ; Vachenauer, Robert ; Desbiolles, Lotus ; Gaemperli, Oliver ; Schepis, Tiziano ; Frauenfelder, Thomas ; Schertler, Thomas ; Husmann, Lars ; Grunenfelder, Jürg ; Genoni, Michele ; Kaufmann, Philipp A ; Marincek, Borut ; Leschka, Sebastian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-2643cb3bb90a56210c48119ffe0234320f36bbccdcd7c0fe74521bb318abc1913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Cardiac</topic><topic>Cardiovascular disease</topic><topic>Chi-Square Distribution</topic><topic>Computed tomography</topic><topic>Coronary Angiography - methods</topic><topic>Coronary artery disease</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Diagnostic systems</topic><topic>Disease control</topic><topic>Female</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Image quality</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Population studies</topic><topic>Predictive Value of Tests</topic><topic>Ratings</topic><topic>Risk Factors</topic><topic>Segments</topic><topic>Sensitivity analysis</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scheffel, Hans</creatorcontrib><creatorcontrib>Alkadhi, Hatem</creatorcontrib><creatorcontrib>Plass, André</creatorcontrib><creatorcontrib>Vachenauer, Robert</creatorcontrib><creatorcontrib>Desbiolles, Lotus</creatorcontrib><creatorcontrib>Gaemperli, Oliver</creatorcontrib><creatorcontrib>Schepis, Tiziano</creatorcontrib><creatorcontrib>Frauenfelder, Thomas</creatorcontrib><creatorcontrib>Schertler, Thomas</creatorcontrib><creatorcontrib>Husmann, Lars</creatorcontrib><creatorcontrib>Grunenfelder, Jürg</creatorcontrib><creatorcontrib>Genoni, Michele</creatorcontrib><creatorcontrib>Kaufmann, Philipp A</creatorcontrib><creatorcontrib>Marincek, Borut</creatorcontrib><creatorcontrib>Leschka, Sebastian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scheffel, Hans</au><au>Alkadhi, Hatem</au><au>Plass, André</au><au>Vachenauer, Robert</au><au>Desbiolles, Lotus</au><au>Gaemperli, Oliver</au><au>Schepis, Tiziano</au><au>Frauenfelder, Thomas</au><au>Schertler, Thomas</au><au>Husmann, Lars</au><au>Grunenfelder, Jürg</au><au>Genoni, Michele</au><au>Kaufmann, Philipp A</au><au>Marincek, Borut</au><au>Leschka, Sebastian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control</atitle><jtitle>European radiology</jtitle><addtitle>Eur Radiol</addtitle><date>2006-12-01</date><risdate>2006</risdate><volume>16</volume><issue>12</issue><spage>2739</spage><epage>2747</epage><pages>2739-2747</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14+/-9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter > or =1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3+/-3.9 kg/m2 (range 22.4-36.3 kg/m2), mean heart rate during CT was 70.3+/-14.2 bpm (range 47-102 bpm), and mean Agatston score was 821+/-904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68+/-0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>17031451</pmid><doi>10.1007/s00330-006-0474-0</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Adult Aged Aged, 80 and over Angiography Body mass index Body size Calcinosis - diagnostic imaging Cardiac Cardiovascular disease Chi-Square Distribution Computed tomography Coronary Angiography - methods Coronary artery disease Coronary Disease - diagnostic imaging Diagnostic systems Disease control Female Heart diseases Heart rate Heart Rate - physiology Humans Image quality Male Medical imaging Middle Aged Population studies Predictive Value of Tests Ratings Risk Factors Segments Sensitivity analysis Sensitivity and Specificity Tomography, X-Ray Computed |
| title | Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control |
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