Diagnostic accuracy of 16-slice CT coronary angiography in the evaluation of coronary artery disease

K. H. Soon, I. Chaitowitz, N. Cox, L. MacGregor, D. Eccleston, K. W. Bell, A. M. Kelly, Y. L. Lim

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Multislice CT coronary angiography (CT-CA) has emerged as a potential imaging method for coronary artery disease. This study aimed to ascertain the accuracy of 16-slice CT in the diagnosis of significant coronary stenosis (≥50% reduction of lumen diameter). This mixed retrospective/prospective observational study compared 95 paired 16-slice CT-CA and fluoroscopic coronary angiography (FCA) sets. A cardiologist and a radiologist blinded to the FCA findings evaluated CT-CA images independently by visual estimation. Disagreement between these reporters was arbitrated by a third CT reporter (a cardiologist). A separate cardiologist blinded to CT-CA findings assessed FCA by visual estimation. Of 1161 coronary segments assessable on FCA, 1103 segments (95%) were assessable on CT-CA. The CT-CA correctly diagnosed 147/180 segments with significant stenoses (sensitivity = 82%) and correctly identified 874/923 coronary segments without significant stenoses (specificity = 95%). The positive and negative predictive values of CT-CA in the diagnosis of coronary segment with significant stenosis were 75 and 96%, respectively. On patient-based analysis, CT-CA correctly identified all 68 studies with at least one vessel with significant stenosis (sensitivity = 100%; specificity = 83%). The positive and negative predictive values of CT-CA in identifying patients with significant coronary stenosis were 94 and 100%, respectively. The 16-slice CT-CA showed moderately good sensitivity but very high specificity and negative predictive value in the diagnosis of significant coronary stenosis. The CT-CA would appear to be a useful 'rule-out' test for patients with low-risk profile for ischaemic heart disease.

Original languageEnglish (US)
Pages (from-to)365-369
Number of pages5
JournalAustralasian Radiology
Volume51
Issue number4
DOIs
StatePublished - Aug 1 2007

Keywords

  • 16-slice CT
  • Coronary angiography
  • MSCT
  • Stenosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Soon, K. H., Chaitowitz, I., Cox, N., MacGregor, L., Eccleston, D., Bell, K. W., Kelly, A. M., & Lim, Y. L. (2007). Diagnostic accuracy of 16-slice CT coronary angiography in the evaluation of coronary artery disease. Australasian Radiology, 51(4), 365-369. https://doi.org/10.1111/j.1440-1673.2007.01725.x