Related Experiment Video
Updated: Jul 10, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary arteries: diagnostic performance of 16- versus 64-section spiral CT compared with invasive coronary
Michèle Hamon1, Rémy Morello, John W Riddell
1Department of Radiology, University Hospital of Caen, Avenue Côte de Nacre, 14033 Caen Cedex, Normandy, France. hamon-mi@chu-caen.fr
Insights
Sixty-four-section computed tomography (CT) shows superior diagnostic performance for coronary artery disease (CAD) compared to 16-section CT. This meta-analysis highlights improved specificity and positive predictive value for detecting significant coronary artery stenosis with the newer technology.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Accurate non-invasive diagnostic tools are crucial for timely intervention.
- Advancements in computed tomography (CT) technology offer potential improvements in CAD detection.
Purpose of the Study:
- To conduct a meta-analysis comparing the diagnostic accuracy of 16-section versus 64-section CT for CAD.
- To evaluate the performance of these CT modalities in detecting obstructive coronary artery stenosis.
Main Methods:
- A systematic literature search was performed on the MEDLINE database for relevant original articles.
- Inclusion criteria specified the use of multisection spiral CT (16 or 64 section) and coronary angiography as the reference standard (>50% diameter stenosis).
- A random-effects model was employed for data analysis, with assessment of statistical heterogeneity using Cochran Q chi(2) tests.
Main Results:
- The meta-analysis included data from 28 studies (1292 patients for 16-section CT, 695 patients for 64-section CT).
- Sixty-four-section CT demonstrated significantly higher specificity (90% vs. 69%), positive predictive value (93% vs. 79%), and negative predictive value (96% vs. 92%) compared to 16-section CT (all P < .001).
- Sensitivity was also higher for 64-section CT (97% vs. 95%, P = .03).
Conclusions:
- Sixty-four-section spiral CT offers significantly improved diagnostic performance over 16-section CT for detecting coronary artery stenosis.
- The enhanced specificity and positive predictive value of 64-section CT are critical for accurate CAD diagnosis on a per-patient basis.
Purpose:
To perform a meta-analysis to compare the diagnostic performance of 16- versus 64-section computed tomography (CT) for the diagnosis of coronary artery disease (CAD).
Materials And Methods:
The MEDLINE database was searched for relevant original articles. Criteria for inclusion of articles were (a) use of multisection spiral CT as a diagnostic test for obstructive CAD, (b) use of the newer generation of multisection spiral CT (16 or 64 section) scanners, and (c) use of coronary angiography as the reference standard for diagnosing obstructive CAD (>50% diameter stenosis was selected as the cutoff criterion for diagnosis of CAD). After data extraction, the analysis was performed according to a random-effects model. Between-study statistical heterogeneity also was assessed by using Cochran Q chi(2) tests.
Results:
Of 328 identified relevant articles, 37 fulfilled all inclusion criteria, with data available for a patient-based analysis in 28. The patient-based analysis included pooled data from 16 studies, corresponding to 1292 patients who underwent 16-section spiral CT, and from 12 studies, corresponding to 695 patients who underwent 64-section spiral CT. Respectively, the results for 16-section CT versus 64-section CT were 95% (95% confidence interval [CI]: 93%, 96%) versus 97% (95% CI: 95%, 98%) for sensitivity (P = .03), 69% (95% CI: 66%, 73%) versus 90% (95% CI: 86%, 93%) for specificity (P < .001), 79% (95% CI: 76%, 82%) versus 93% (95% CI: 91%, 96%) for positive predictive value (PPV) (P < .001), 92% (95% CI: 88%, 94%) versus 96% (95% CI: 92%, 98%) for negative predictive value (P < .001), and 72.05 (95% CI: 31.35, 165.56) versus 181.82 (95% CI: 88.70, 372.71) for diagnostic odds ratio (P = .1).
Conclusion:
Sixty-four-section spiral CT has significantly higher specificity and PPV on a per-patient basis compared with 16-section CT for the detection of greater than 50% stenosis of coronary arteries.
Supplemental Material:
http://radiology.rsnajnls.org/cgi/content/full/2453061899/DC1.
More Related Videos
06:57Semi-Automatic Graphical Tool for Measuring Coronary Artery Spatially Weighted Calcium Score from Gated Cardiac Computed Tomography Images
Published on: September 22, 2023
10:28Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...