Computed tomography for detecting coronary artery plaques: a meta-analysis.

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Coronary artery plaque detection is crucial for managing cardiovascular disease.
• Computed tomography (CT) offers a noninvasive method for assessing coronary artery plaques.
• Systematic validation of CT's accuracy in detecting and quantifying plaque in vivo is needed.

Purpose of the Study:

• To conduct a meta-analysis evaluating the accuracy of Computed tomography (CT) in detecting coronary artery plaques.
• To compare CT's performance against intravascular ultrasound (IVUS) as the reference standard.

Main Methods:

• Systematic literature search of studies comparing CT and IVUS for coronary plaque assessment (1966-January 2011).
• Inclusion of studies reporting true positive, false positive, false negative, and true negative results.
• Bivariate and covariate analyses to determine sensitivity and specificity.

Main Results:

• Meta-analysis of 17 studies demonstrated high accuracy for CT in detecting coronary artery plaques.
• Mean sensitivity and specificity for any plaque detection were 92% and 93%, respectively.
• CT scanners with >16 rows showed significantly higher sensitivity (95%) and specificity (94%) compared to older scanners.

Conclusions:

• Computed tomography (CT) is a leading noninvasive alternative to IVUS for detecting coronary artery plaques.
• Further randomized, patient-level studies are required to establish CT's role in triage and management of coronary artery disease.