Clinical research study64-Slice CT for Diagnosis of Coronary Artery Disease: A Systematic Review
Section snippets
Methods
We used several sources to guide our review process, including recommendations by Lijmer et al concerning avoidance of bias in studies of diagnostic tests,2 review of methods of systematic review,3 and the Standards for Reporting Diagnostic Accuracy statement for reporting studies of diagnostic accuracy.4
Results
All but 3 investigators5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 25, 26, 27, 28, 29, 30, 31, 33, 34, 35, 36, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 used a Siemens Somatom 64 (Siemens Medical Solutions, Erlangen, Germany) exclusively. Cademartiri et al used both a Siemens Sensation 64 and an Aquilion 64 (Toshiba Medical Systems, Tochigi Prefecture, Japan).24 An Aquilion 64 was used exclusively by 2 groups.32, 37 Reasons for the individual investigations were
Discussion
Sensitivity of 64-slice CT coronary angiography, for significant stenosis, based on pooled data from all studies, was ≥90% in patient-based evaluations, named vessels, and segments, except the left circumflex (sensitivity 88%), distal segments (80%), and stents (88%). Specificity was 88% in patient-based evaluations, and ≥90% for all individual sites.
Compared with 16-slice CT, the sensitivity of 64-slice CT coronary angiography for significant stenosis was higher in patient-based analyses, 98%
Conclusion
Sixty-four-slice CT coronary angiography in most vessels and segments of vessels is sensitive and specific. A positive 64-slice CT in the left main coronary artery and in coronary artery bypass grafts showed few false positives. At other sites, positive predictive values, due to the low prevalence of disease at any specific site, suggest that stenoses shown on 64-slice CT require confirmation. A negative 64-slice CT coronary angiogram reliably excluded significant coronary artery disease.
References (56)
- et al.
The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients
Ann Emerg Med
(2007) - et al.
Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography
J Am Coll Cardiol
(2005) - et al.
Noninvasive coronary angiography using 64-slice spiral computed tomography in an unselected patient collective: effect of heart rate, heart rate variability and coronary calcifications on image quality and diagnostic accuracy
Eur J Radiol
(2008) - et al.
Diagnostic accuracy of coronary in-stent restenosis using 64-slice computed tomography: comparison with invasive coronary angiography
J Am Coll Cardiol
(2007) - et al.
Assessment of coronary artery stent patency and restenosis using 64-slice computed tomography
Acad Radiol
(2006) - et al.
Improved noninvasive assessment of coronary artery bypass grafts with 64-slice computed tomographic angiography in an unselected patient population
J Am Coll Cardiol
(2007) - et al.
Evaluation of coronary artery bypass grafts and native coronary arteries using 64-slice multidetector computed tomography
Am Heart J
(2007) - et al.
Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound
J Am Coll Cardiol
(2005) - et al.
Usefulness of multidetector row spiral computed tomography with 64- × 0.6-mm collimation and 330-ms rotation for the noninvasive detection of significant coronary artery stenoses
Am J Cardiol
(2006) - et al.
Usefulness of 64-slice multislice computed tomography coronary angiography to assess in-stent restenosis
J Am Coll Cardiol
(2007)