Diagnostic accuracy of low-dose 256-slice multi-detector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease |
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Authors: | Yang Hou Yue Ma Weipeng Fan Yuke Wang Mei Yu Mani Vembar Qiyong Guo |
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Institution: | 1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China 2. Department of Radiology, Central Hospital of Anshan, Anshan, 114001, China 3. CT Clinical Science Philips Healthcare, Cleveland, OH, 44143, USA
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Abstract: | Objectives To evaluate the accuracy of low-dose coronary CTA with iterative reconstruction (IR) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD. Methods Ninety-six patients with suspected CAD underwent low-dose prospective electrocardiogram-gated coronary CTA, with images reconstructed using IR. Image quality (IQ) of coronary segments were graded on a 4-point scale (4, excellent; 1, non-diagnostic). With invasive coronary angiography (ICA) considered the “gold standard”, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of coronary CTA were calculated on segment-, vessel- and patient-based levels. The patient data were divided into two groups (Agatston scores of ≥ 400 and <400). The differences in diagnostic performance between the two groups were tested. Results Diagnostic image quality was found in 98.1 % (1,232/1,256) of segments. The sensitivity, specificity, PPV, NPV and accuracy were 90.8 %, 95.3 %, 81.8 %, 97.8 % and 94.3 % (segment-based) and 97.2 %, 83.3 %, 94.6 %, 90.9 % and 93.8 % (patient-based). Significant differences between the two groups were seen in specificity, PPV and accuracy (92.1 % vs. 97.9 %, 76.0 % vs. 86.7 %, 91.7 % vs. 96.6 %, P?<?0.05; segment-based). The average effective dose was 1.30?±?0.15 mSv. Conclusion Low-dose prospective coronary CTA with IR can acquire satisfactory image quality and show high diagnostic accuracy in patients with suspected CAD; however, blooming continues to pose a challenge in severely calcified segments. Key Points ? Coronary artery disease (CAD) is increasingly investigated using coronary CTA. ? The iterative reconstruction (IR) algorithm is promising in decreasing radiation doses. ? Low-dose prospective coronary CTA with IR can acquire satisfactory image quality. ? Low-dose prospective coronary CTA with IR can show high diagnostic accuracy. |
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