Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner-Facing the Facts

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Radiology

Background:

• Multislice computed tomography (MSCT) angiography has advanced minimally invasive detection of coronary artery stenoses.
• Quantitative coronary angiography (QCA) remains the reference standard for evaluating coronary artery stenoses.
• Previous MSCT generations showed promising results, leading to the development of 64-slice scanners.

Purpose of the Study:

• To evaluate the diagnostic accuracy, sensitivity, specificity, and predictive values of 64-slice MSCT angiography.
• To assess the detection of haemodynamically significant coronary artery stenoses using 64-slice MSCT.
• To compare 64-slice MSCT angiography results with QCA in patients with suspected coronary artery disease.

Main Methods:

• Thirty-seven consecutive subjects with suspected coronary artery disease underwent 64-slice MSCT angiography.
• Results were compared with QCA, considering all coronary vessels for stenosis assessment (diameter reduction >/= 50%).
• Interobserver variability was assessed using a k-value.

Main Results:

• Sixty-four-slice MSCT demonstrated an overall sensitivity of 69% and specificity of 92% for detecting significant coronary artery stenoses.
• The positive predictive value was 38%, and the negative predictive value was 98%.
• Interobserver variability for detecting significant lesions had a k-value of 0.43.

Conclusions:

• Sixty-four-slice MSCT angiography has diagnostic potential for detecting coronary artery disease.
• It can quantify haemodynamically significant coronary artery stenoses.
• This non-invasive method may help avoid unnecessary invasive coronary artery examinations.