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Protocol and performance of coronary computed tomography angiography in patients with atrial fibrillation: a

X-Z Yang1, S Hachaichi2, J Endrikat3

  • 1Bayer China, Medical Department. Chaoyang District 100020 Beijing, China.

Clinical Radiology
|December 9, 2025
PubMed

Insights

Coronary computed tomography angiography (CCTA) using iopromide contrast effectively diagnoses coronary artery disease (CAD) in patients with atrial fibrillation (AF). Optimized protocols and scanners enhance image quality while reducing radiation exposure.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Atrial fibrillation (AF) presents challenges for diagnosing coronary artery disease (CAD) using computed tomography angiography (CCTA).
  • Iopromide contrast agent performance in CCTA for AF patients requires systematic evaluation.

Purpose of the Study:

  • To systematically investigate protocols and diagnostic performance of iopromide contrast-enhanced CCTA for CAD in patients with AF.
  • To assess image quality, radiation dose, and diagnostic accuracy metrics.

Main Methods:

  • Systematic literature search of PubMed, Embase, Web of Science, and Cochrane Library up to February 2025.
  • Meta-analysis of 14 studies (601 patients) using iopromide 370 mgI/ml CCTA.
  • Pooled analysis of diagnostic segments, effective radiation dose, sensitivity, specificity, and ROC curves.

Main Results:

  • 98% of segments were diagnostic in patients with AF (95% CI: 0.96-0.99).
  • Per-patient ROC was 0.97 (95% CI: 0.95-0.98); per-segment ROC was 0.99 (95% CI: 0.98-0.99).
  • Individualized protocols and high-performance scanners improved image quality; prospective protocols reduced radiation dose by ~50%.

Conclusions:

  • Iopromide 370 mgI/ml CCTA provides consistent image quality and accurate CAD diagnosis in AF patients.
  • High-performance scanners, individualized protocols, and prospective acquisition enhance image quality and reduce radiation exposure.
Abstract

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