Diagnostic Accuracy of Coronary Computed Tomography Angiography. A Comparison Between Prospective and Retrospective Electrocardiogram Triggering

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Abstract

Objectives: The aim of this study was to compare the diagnostic performance of multidetector computed tomography (MDCT) with prospective electrocardiogram (ECG) triggering versus retrospective ECG triggering. Background: MDCT allows the noninvasive visualization of the coronary arteries. However, radiation exposure is a reason for concern. Methods: One hundred eighty consecutive patients scheduled for invasive coronary angiography were enrolled in this study. Twenty patients were excluded due to contraindications to sustain MDCT. Of the 160 remaining patients, 80 were studied with MDCT with prospective ECG triggering (Group 1) and 80 with a retrospective ECG triggering (Group 2). The individual radiation dose exposure was estimated. Results: In nonstented segments, the evaluability of Groups 1 and 2 was 96% versus 97%, respectively (p = 0.05), the accuracy in segment-based model was 93% versus 96%, respectively (p <0.05) including diagnostic segments and 91% versus 94%, respectively (p <0.01) including all segments, whereas the accuracy in a patient-based model was 98% in both groups. In stented segments the evaluability in Groups 1 and 2 was 92% versus 94%, respectively, and the accuracy was 93% versus 92%, respectively, including diagnostic stented segments and 90% versus 89%, respectively, including all stented segments. Group 1 presented lower radiation dose compared with Group 2 (5.7 ± 1.5 mSv vs. 20.5 ± 4.3 mSv, p <0.01). Conclusions: Prospective ECG-triggering computed tomography allows an accurate detection of coronary stenosis, despite a slight reduction of diagnostic performance, with a low radiation dose.

Original languageEnglish
Pages (from-to)346-355
Number of pages10
JournalJournal of the American College of Cardiology
Volume54
Issue number4
DOIs
Publication statusPublished - Jul 21 2009

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Multidetector Computed Tomography
Electrocardiography
Radiation
Coronary Stenosis
Coronary Angiography
Coronary Vessels
Tomography
Computed Tomography Angiography
Radiation Exposure

Keywords

  • accuracy
  • evaluability
  • low dose
  • multidetector computed tomography
  • prospective ECG triggering

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{fcae24b4d105440bb076b868f9f135b4,
title = "Diagnostic Accuracy of Coronary Computed Tomography Angiography. A Comparison Between Prospective and Retrospective Electrocardiogram Triggering",
abstract = "Objectives: The aim of this study was to compare the diagnostic performance of multidetector computed tomography (MDCT) with prospective electrocardiogram (ECG) triggering versus retrospective ECG triggering. Background: MDCT allows the noninvasive visualization of the coronary arteries. However, radiation exposure is a reason for concern. Methods: One hundred eighty consecutive patients scheduled for invasive coronary angiography were enrolled in this study. Twenty patients were excluded due to contraindications to sustain MDCT. Of the 160 remaining patients, 80 were studied with MDCT with prospective ECG triggering (Group 1) and 80 with a retrospective ECG triggering (Group 2). The individual radiation dose exposure was estimated. Results: In nonstented segments, the evaluability of Groups 1 and 2 was 96{\%} versus 97{\%}, respectively (p = 0.05), the accuracy in segment-based model was 93{\%} versus 96{\%}, respectively (p <0.05) including diagnostic segments and 91{\%} versus 94{\%}, respectively (p <0.01) including all segments, whereas the accuracy in a patient-based model was 98{\%} in both groups. In stented segments the evaluability in Groups 1 and 2 was 92{\%} versus 94{\%}, respectively, and the accuracy was 93{\%} versus 92{\%}, respectively, including diagnostic stented segments and 90{\%} versus 89{\%}, respectively, including all stented segments. Group 1 presented lower radiation dose compared with Group 2 (5.7 ± 1.5 mSv vs. 20.5 ± 4.3 mSv, p <0.01). Conclusions: Prospective ECG-triggering computed tomography allows an accurate detection of coronary stenosis, despite a slight reduction of diagnostic performance, with a low radiation dose.",
keywords = "accuracy, evaluability, low dose, multidetector computed tomography, prospective ECG triggering",
author = "Gianluca Pontone and Daniele Andreini and Bartorelli, {Antonio L.} and Sarah Cortinovis and Saima Mushtaq and Erika Bertella and Andrea Annoni and Alberto Formenti and Enrica Nobili and Daniela Trabattoni and Piero Montorsi and Giovanni Ballerini and Piergiuseppe Agostoni and Mauro Pepi",
year = "2009",
month = "7",
day = "21",
doi = "10.1016/j.jacc.2009.04.027",
language = "English",
volume = "54",
pages = "346--355",
journal = "Journal of the American College of Cardiology",
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publisher = "Elsevier USA",
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TY - JOUR

T1 - Diagnostic Accuracy of Coronary Computed Tomography Angiography. A Comparison Between Prospective and Retrospective Electrocardiogram Triggering

AU - Pontone, Gianluca

AU - Andreini, Daniele

AU - Bartorelli, Antonio L.

AU - Cortinovis, Sarah

AU - Mushtaq, Saima

AU - Bertella, Erika

AU - Annoni, Andrea

AU - Formenti, Alberto

AU - Nobili, Enrica

AU - Trabattoni, Daniela

AU - Montorsi, Piero

AU - Ballerini, Giovanni

AU - Agostoni, Piergiuseppe

AU - Pepi, Mauro

PY - 2009/7/21

Y1 - 2009/7/21

N2 - Objectives: The aim of this study was to compare the diagnostic performance of multidetector computed tomography (MDCT) with prospective electrocardiogram (ECG) triggering versus retrospective ECG triggering. Background: MDCT allows the noninvasive visualization of the coronary arteries. However, radiation exposure is a reason for concern. Methods: One hundred eighty consecutive patients scheduled for invasive coronary angiography were enrolled in this study. Twenty patients were excluded due to contraindications to sustain MDCT. Of the 160 remaining patients, 80 were studied with MDCT with prospective ECG triggering (Group 1) and 80 with a retrospective ECG triggering (Group 2). The individual radiation dose exposure was estimated. Results: In nonstented segments, the evaluability of Groups 1 and 2 was 96% versus 97%, respectively (p = 0.05), the accuracy in segment-based model was 93% versus 96%, respectively (p <0.05) including diagnostic segments and 91% versus 94%, respectively (p <0.01) including all segments, whereas the accuracy in a patient-based model was 98% in both groups. In stented segments the evaluability in Groups 1 and 2 was 92% versus 94%, respectively, and the accuracy was 93% versus 92%, respectively, including diagnostic stented segments and 90% versus 89%, respectively, including all stented segments. Group 1 presented lower radiation dose compared with Group 2 (5.7 ± 1.5 mSv vs. 20.5 ± 4.3 mSv, p <0.01). Conclusions: Prospective ECG-triggering computed tomography allows an accurate detection of coronary stenosis, despite a slight reduction of diagnostic performance, with a low radiation dose.

AB - Objectives: The aim of this study was to compare the diagnostic performance of multidetector computed tomography (MDCT) with prospective electrocardiogram (ECG) triggering versus retrospective ECG triggering. Background: MDCT allows the noninvasive visualization of the coronary arteries. However, radiation exposure is a reason for concern. Methods: One hundred eighty consecutive patients scheduled for invasive coronary angiography were enrolled in this study. Twenty patients were excluded due to contraindications to sustain MDCT. Of the 160 remaining patients, 80 were studied with MDCT with prospective ECG triggering (Group 1) and 80 with a retrospective ECG triggering (Group 2). The individual radiation dose exposure was estimated. Results: In nonstented segments, the evaluability of Groups 1 and 2 was 96% versus 97%, respectively (p = 0.05), the accuracy in segment-based model was 93% versus 96%, respectively (p <0.05) including diagnostic segments and 91% versus 94%, respectively (p <0.01) including all segments, whereas the accuracy in a patient-based model was 98% in both groups. In stented segments the evaluability in Groups 1 and 2 was 92% versus 94%, respectively, and the accuracy was 93% versus 92%, respectively, including diagnostic stented segments and 90% versus 89%, respectively, including all stented segments. Group 1 presented lower radiation dose compared with Group 2 (5.7 ± 1.5 mSv vs. 20.5 ± 4.3 mSv, p <0.01). Conclusions: Prospective ECG-triggering computed tomography allows an accurate detection of coronary stenosis, despite a slight reduction of diagnostic performance, with a low radiation dose.

KW - accuracy

KW - evaluability

KW - low dose

KW - multidetector computed tomography

KW - prospective ECG triggering

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