Accuratezza diagnostica dell'angiografia coronarica con tomografia computerizzata a doppia sorgente di seconda generazione con ricostruzioni iterative

Valutazione nel mondo reale

Translated title of the contribution: Diagnostic accuracy of second-generation dual-source computed tomography coronary angiography with iterative reconstructions: A real-world experience

E. Maffei, C. Martini, A. Rossi, N. Mollet, C. Lario, M. Castiglione Morelli, A. Clemente, G. Gentile, T. Arcadi, S. Seitun, O. Catalano, A. Aldrovandi, F. Cademartiri

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose. The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). Materials and methods. Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70.100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50% and ≥70%, respectively. Results. No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30% (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1%, 93.3%, 53.2% and 99.1% (per segment), 97.5%, 91.2%, 61.4% and 99.6% (per vessel) and 100%, 83%, 71.6% and 100% (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. Conclusions. CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.

Original languageItalian
Pages (from-to)725-738
Number of pages14
JournalRadiologia Medica
Volume117
Issue number5
DOIs
Publication statusPublished - Aug 2012

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Coronary Angiography
Coronary Artery Disease
Pathologic Constriction
Computed Tomography Angiography
Validation Studies
Contrast Media
Heart Rate
Radiation
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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Accuratezza diagnostica dell'angiografia coronarica con tomografia computerizzata a doppia sorgente di seconda generazione con ricostruzioni iterative : Valutazione nel mondo reale. / Maffei, E.; Martini, C.; Rossi, A.; Mollet, N.; Lario, C.; Morelli, M. Castiglione; Clemente, A.; Gentile, G.; Arcadi, T.; Seitun, S.; Catalano, O.; Aldrovandi, A.; Cademartiri, F.

In: Radiologia Medica, Vol. 117, No. 5, 08.2012, p. 725-738.

Research output: Contribution to journalArticle

Maffei, E, Martini, C, Rossi, A, Mollet, N, Lario, C, Morelli, MC, Clemente, A, Gentile, G, Arcadi, T, Seitun, S, Catalano, O, Aldrovandi, A & Cademartiri, F 2012, 'Accuratezza diagnostica dell'angiografia coronarica con tomografia computerizzata a doppia sorgente di seconda generazione con ricostruzioni iterative: Valutazione nel mondo reale', Radiologia Medica, vol. 117, no. 5, pp. 725-738. https://doi.org/10.1007/s11547-011-0754-x
Maffei, E. ; Martini, C. ; Rossi, A. ; Mollet, N. ; Lario, C. ; Morelli, M. Castiglione ; Clemente, A. ; Gentile, G. ; Arcadi, T. ; Seitun, S. ; Catalano, O. ; Aldrovandi, A. ; Cademartiri, F. / Accuratezza diagnostica dell'angiografia coronarica con tomografia computerizzata a doppia sorgente di seconda generazione con ricostruzioni iterative : Valutazione nel mondo reale. In: Radiologia Medica. 2012 ; Vol. 117, No. 5. pp. 725-738.
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abstract = "Purpose. The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). Materials and methods. Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70.100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50{\%} and ≥70{\%}, respectively. Results. No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30{\%} (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1{\%}, 93.3{\%}, 53.2{\%} and 99.1{\%} (per segment), 97.5{\%}, 91.2{\%}, 61.4{\%} and 99.6{\%} (per vessel) and 100{\%}, 83{\%}, 71.6{\%} and 100{\%} (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. Conclusions. CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.",
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author = "E. Maffei and C. Martini and A. Rossi and N. Mollet and C. Lario and Morelli, {M. Castiglione} and A. Clemente and G. Gentile and T. Arcadi and S. Seitun and O. Catalano and A. Aldrovandi and F. Cademartiri",
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T2 - Valutazione nel mondo reale

AU - Maffei, E.

AU - Martini, C.

AU - Rossi, A.

AU - Mollet, N.

AU - Lario, C.

AU - Morelli, M. Castiglione

AU - Clemente, A.

AU - Gentile, G.

AU - Arcadi, T.

AU - Seitun, S.

AU - Catalano, O.

AU - Aldrovandi, A.

AU - Cademartiri, F.

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N2 - Purpose. The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). Materials and methods. Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70.100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50% and ≥70%, respectively. Results. No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30% (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1%, 93.3%, 53.2% and 99.1% (per segment), 97.5%, 91.2%, 61.4% and 99.6% (per vessel) and 100%, 83%, 71.6% and 100% (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. Conclusions. CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.

AB - Purpose. The authors evaluated the diagnostic accuracy of second-generation dual-source (DSCT) computed tomography coronary angiography (CTCA) with iterative reconstructions for detecting obstructive coronary artery disease (CAD). Materials and methods. Between June 2010 and February 2011, we enrolled 160 patients (85 men; mean age 61.2±11.6 years) with suspected CAD. All patients underwent CTCA and conventional coronary angiography (CCA). For the CTCA scan (Definition Flash, Siemens), we use prospective tube current modulation and 70.100 ml of iodinated contrast material (Iomeprol 400 mgI/ ml, Bracco). Data sets were reconstructed with iterative reconstruction algorithm (IRIS, Siemens). CTCA and CCA reports were used to evaluate accuracy using the threshold for significant stenosis at ≥50% and ≥70%, respectively. Results. No patient was excluded from the analysis. Heart rate was 64.3±11.9 bpm and radiation dose was 7.2±2.1 mSv. Disease prevalence was 30% (48/160). Sensitivity, specificity and positive and negative predictive values of CTCA in detecting significant stenosis were 90.1%, 93.3%, 53.2% and 99.1% (per segment), 97.5%, 91.2%, 61.4% and 99.6% (per vessel) and 100%, 83%, 71.6% and 100% (per patient), respectively. Positive and negative likelihood ratios at the per-patient level were 5.89 and 0.0, respectively. Conclusions. CTCA with second-generation DSCT in the real clinical world shows a diagnostic performance comparable with previously reported validation studies. The excellent negative predictive value and likelihood ratio make CTCA a first-line noninvasive method for diagnosing obstructive CAD.

KW - Clinical value

KW - Computed tomography coronary angiography

KW - Conventional coronary angiography

KW - Coronary artery disease

KW - Diagnostic accuracy

KW - Dualsource computed tomography

KW - Iterative reconstructions

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