TY - JOUR
T1 - The impact of training on diagnostic accuracy with computed tomography coronary angiography
AU - Maffei, Erica
AU - Arcadi, Teresa
AU - Zuccarelli, Alessandra
AU - Clemente, Alberto
AU - Torri, Tito
AU - Rossi, Piercarlo
AU - Seitun, Sara
AU - Catalano, Onofrio
AU - Cademartiri, Filippo
PY - 2013/10
Y1 - 2013/10
N2 - Aim The aim of this study is to assess the image quality and diagnostic accuracy of computed tomography (CT) coronary angiography (CTCA) in different hospital settings with the same trained team. Materials and methods Four hundred patients were consecutively enrolled for CTCA in a large academic hospital (Group 1; Sensation 64 Cardiac, Siemens - Iomeprol 400, Bracco; 200 patients) and in a small local hospital (Group 2; VCT, GE Healthcare - Iodixanol 320, GE Healthcare; 200 patients). All patients were enrolled for suspected coronary artery disease (CAD) and patients with stents or who had previously undergone coronary bypass were excluded. Scan protocols (retrospectively ECG-gated; no dose reduction modulation applied) were performed in accordance with standards reported in the international literature with the best solution available on site. Image quality was assessed in each coronary segment with a 4-point Likert scale: 0, not assessable; 1, low; 2, average; 3, good. Diagnostic accuracy was calculated against conventional coronary angiography with a threshold of at least 50% for significant stenosis. Results There was no significant difference between demographics, BMI, prevalence of obstructive CAD, calcium score and heart rate between the two populations. The average image quality was 2.83W0.37 for Group 1 and 2.86W0.31 for Group 2 (P>0.05). Per-segment sensitivity, specificity, positive and negative predictive values were 92.6% (87-95), 97.9% (97-98), 75.9% (69-81) and 99.5% (99-99), respectively, for Group 1, and 90.4% (85-93), 98.6% (98-99), 84.2% (78-88) and 99.2% (98-99), respectively, for Group 2 (P>0.05). Conclusion There is no significant difference in image quality and diagnostic accuracy of CTCA when the investigation is performed by the same properly trained team. CTCA is a robust imaging modality for the detection of coronary artery stenosis.
AB - Aim The aim of this study is to assess the image quality and diagnostic accuracy of computed tomography (CT) coronary angiography (CTCA) in different hospital settings with the same trained team. Materials and methods Four hundred patients were consecutively enrolled for CTCA in a large academic hospital (Group 1; Sensation 64 Cardiac, Siemens - Iomeprol 400, Bracco; 200 patients) and in a small local hospital (Group 2; VCT, GE Healthcare - Iodixanol 320, GE Healthcare; 200 patients). All patients were enrolled for suspected coronary artery disease (CAD) and patients with stents or who had previously undergone coronary bypass were excluded. Scan protocols (retrospectively ECG-gated; no dose reduction modulation applied) were performed in accordance with standards reported in the international literature with the best solution available on site. Image quality was assessed in each coronary segment with a 4-point Likert scale: 0, not assessable; 1, low; 2, average; 3, good. Diagnostic accuracy was calculated against conventional coronary angiography with a threshold of at least 50% for significant stenosis. Results There was no significant difference between demographics, BMI, prevalence of obstructive CAD, calcium score and heart rate between the two populations. The average image quality was 2.83W0.37 for Group 1 and 2.86W0.31 for Group 2 (P>0.05). Per-segment sensitivity, specificity, positive and negative predictive values were 92.6% (87-95), 97.9% (97-98), 75.9% (69-81) and 99.5% (99-99), respectively, for Group 1, and 90.4% (85-93), 98.6% (98-99), 84.2% (78-88) and 99.2% (98-99), respectively, for Group 2 (P>0.05). Conclusion There is no significant difference in image quality and diagnostic accuracy of CTCA when the investigation is performed by the same properly trained team. CTCA is a robust imaging modality for the detection of coronary artery stenosis.
KW - Computed tomography coronary angiography
KW - Conventional coronary angiography
KW - Coronary artery disease
KW - Diagnostic accuracy
KW - Training
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U2 - 10.2459/JCM.0b013e32835ec746
DO - 10.2459/JCM.0b013e32835ec746
M3 - Article
C2 - 24335883
AN - SCOPUS:84885411694
VL - 14
SP - 719
EP - 725
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 10
ER -