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Diagnostic accuracy of coronary ct angiography performed in 100 consecutive patients with coronary stents using a novel whole-organ high-definition ct scanner

Session Present and future of Nuclear Cardiology/Compted Tomography imaging for clinical purpose

Speaker Edoardo Conte

Event : EuroEcho 2017

  • Topic : imaging
  • Sub-topic : Computed Tomography
  • Session type : Moderated Posters

Authors : D Andreini (Milan,IT), S Mushtaq (Milan,IT), E Conte (Milan,IT), M Guglielmo (Milan,IT), A Baggiano (Milan,IT), A Santos (Milan,IT), S Zanchi (Milan,IT), E Menotti (Milan,IT), E Mancini (Milan,IT), A Annoni (Milan,IT), A Formenti (Milan,IT), F Fazzari (Milan,IT), M Verdecchia (Milan,IT), G Pontone (Milan,IT), M Pepi (Milan,IT)

Authors:
D Andreini1 , S Mushtaq2 , E Conte2 , M Guglielmo2 , A Baggiano2 , A Santos2 , S Zanchi2 , E Menotti2 , E Mancini2 , A Annoni2 , A Formenti2 , F Fazzari2 , M Verdecchia2 , G Pontone2 , M Pepi2 , 1University of Milan, Foundation Monzino (IRCCS), Center Cardiology, Dpt of Cardiology - Milan - Italy , 2Cardiology Center Monzino IRCCS - Milan - Italy ,

Citation:
European Heart Journal Supplements ( 2017 ) 18 ( Supplement 3 ), iii233

Aims: To evaluate image quality, interpretability, diagnostic accuracy and radiation exposure of coronary CT angiography (CCTA) using a new generation CT scanner in consecutive patients with coronary stents, including those with high heart rate (HR) and atrial fibrillation (AF).

Materials and Methods: We enrolled 100 consecutive patients (85 males, mean age 65±10 years old) with previous coronary stent implantation scheduled for clinically indicated non-emergent invasive coronary angiography (ICA). A novel whole-organ  high-definition CT scanner was used.  Image quality score, using a 4-point Likert scale on a per-stent level, coronary interpretability and diagnostic accuracy vs. ICA were evaluated and the effective dose (ED) was recorded.

Results: Mean HR during the scan was 67±13 bpm. Twenty-six patients had >65 bpm HR during scanning and 13 patients had AF. Overall, image quality was high (Likert=3.2±0.9). Stent interpretability was 95.8% (184/192 stents). Among 192 stented segments, CCTA correctly identified 32 out of 33 with >50% in-stent restenosis (ISR) (sensitivity 97%). In the stented-based analysis, specificity, positive and negative predictive values and diagnostic accuracy for ISR detection was 97%, 86%, 99% and 97%, respectively. Overall, mean ED of CCTA was 2.4±1.2 mSv vs 6.7±1.6 mSv of ICA (p<0.001).

Conclusions: A new whole-organ high-definition CT scanner was able to evaluate coronary stents with high image quality, stent interpretability, diagnostic accuracy and low radiation exposure, also in presence of unfavorable HR and heart rhythm.

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