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Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience

  • Cardiac
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Abstract

Objectives

The objective was to prospectively investigate the diagnostic accuracy of high-pitch (HP) dual-source computed tomography coronary angiography (CTCA) compared with catheter coronary angiography (CCA) for the diagnosis of significant coronary stenoses.

Methods

Thirty-five patients (seven women; mean age 62 ± 8 years) underwent both CTCA and CCA. CTCA was performed with a second-generation dual-source CT system permitting data acquisition at an HP of 3.4. Patients with heart rates >60 bpm were excluded from study enrolment. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a four-point scale (1: excellent to 4: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). CCA served as the standard of reference. Radiation dose values were calculated using the dose-length product.

Results

Diagnostic image quality was found in 99% of all segments (455/459). Non-diagnostic image quality occurred in a single patient with a sudden increase in heart rate immediately before and during CTCA. Taking segments with non-evaluative image quality as positive for disease, the sensitivity, specificity and positive and negative predictive values were 94, 96, 80 and 99% per segment and 100, 91, 88 and 100% per patient. The effective radiation dose was on average 0.9 ± 0.1 mSv.

Conclusion

In patients with heart rates ≤60 bpm, CTCA using the HP mode of the dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at sub-milliSievert doses.

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Authors and Affiliations

  1. Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Sebastian Leschka, Paul Stolzmann, Lotus Desbiolles, Stephan Baumueller, Robert Goetti, Thomas Schertler, Hans Scheffel, Gudrun Feuchtner, Borut Marincek & Hatem Alkadhi

  2. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Andre Plass & Volkmar Falk

  3. Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Hatem Alkadhi

Authors
  1. Sebastian Leschka
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  2. Paul Stolzmann
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  3. Lotus Desbiolles
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  4. Stephan Baumueller
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  5. Robert Goetti
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  6. Thomas Schertler
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  7. Hans Scheffel
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  8. Andre Plass
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  9. Volkmar Falk
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  10. Gudrun Feuchtner
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  11. Borut Marincek
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  12. Hatem Alkadhi
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Corresponding author

Correspondence to Hatem Alkadhi.

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Leschka, S., Stolzmann, P., Desbiolles, L. et al. Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience. Eur Radiol 19, 2896–2903 (2009). https://doi.org/10.1007/s00330-009-1618-9

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  • DOI: https://doi.org/10.1007/s00330-009-1618-9

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