Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis: Assessment of cross-sectional and longitudinal vessel reconstructions

Ricardo C. Cury, Maros Ferencik, Stephan Achenbach, Eugene Pomerantsev, Koen Nieman, Fabian Moselewski, Suhny Abbara, Ik Kyung Jang, Thomas J. Brady, Udo Hoffmann

Research output: Contribution to journalArticle

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Abstract

Background: Sixteen-slice multi-detector computed tomography (MDCT) permits reliable noninvasive detection of significant coronary stenosis based on qualitative visual assessment. The purpose of this study was to determine the accuracy of MDCT to quantify the degree of coronary stenosis as compared to quantitative coronary angiography (QCA) using two different reconstruction methods. Methods: We studied 69 coronary artery lesions from 38 consecutive patients that underwent 16-slice MDCT as a part of research study, which enrolled consecutive subjects scheduled for clinically indicated invasive coronary angiography. Nine coronary artery lesions with motion artifacts, heavily calcified plaques or stents were excluded from the analysis. The degree of stenosis was calculated by two independent readers non-blinded to the location of the stenosis, but blinded to the results of the QCA. MDCT luminal diameters were measured in cross-sectional multi-planar reformatted (CS-MPR) images created perpendicular to the centerline of the vessel and in 5 mm thin-slab maximum intensity projections (MIP) parallel to the long axis of the vessel. Both MDCT methods were compared against QCA. Results: The mean degree of stenosis as measured by MDCT was closely correlated to QCA for both methods (CS-MPR versus QCA: 61 ± 23% versus 64 ± 29%; r2 = 0.83, p <0.001and MIP versus QCA: 64 ± 22% versus 64 ± 29%; r2 = 0.84, p <0.001for MIP. Bland-Altman analysis demonstrated a negative bias of the degree of stenosis of -2.8 ± 12% using CS-MPR and a minimally positive bias of 0.6 ± 12% for MIP. In stratified analysis for lesion severity (mild, 0-40%; moderate, 41-70% or severe, >70%) the agreement between both CS-MPR and MIP was high when compared to QCA (κ = 0.74 and 0.71, respectively). Conclusion: Multi-detector spiral CT permits accurate quantitative assessment of the degree of coronary stenosis in selected data sets of sufficient quality using both cross-sectional and longitudinal vessel reconstructions.

Original languageEnglish (US)
Pages (from-to)345-350
Number of pages6
JournalEuropean Journal of Radiology
Volume57
Issue number3
DOIs
StatePublished - Mar 2006
Externally publishedYes

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Coronary Stenosis
Coronary Angiography
Tomography
Pathologic Constriction
Coronary Vessels
Spiral Computed Tomography
Artifacts
Stents
Research

Keywords

  • Atherosclerosis
  • Computed tomography
  • Coronary artery disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis : Assessment of cross-sectional and longitudinal vessel reconstructions. / Cury, Ricardo C.; Ferencik, Maros; Achenbach, Stephan; Pomerantsev, Eugene; Nieman, Koen; Moselewski, Fabian; Abbara, Suhny; Jang, Ik Kyung; Brady, Thomas J.; Hoffmann, Udo.

In: European Journal of Radiology, Vol. 57, No. 3, 03.2006, p. 345-350.

Research output: Contribution to journalArticle

Cury, Ricardo C. ; Ferencik, Maros ; Achenbach, Stephan ; Pomerantsev, Eugene ; Nieman, Koen ; Moselewski, Fabian ; Abbara, Suhny ; Jang, Ik Kyung ; Brady, Thomas J. ; Hoffmann, Udo. / Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis : Assessment of cross-sectional and longitudinal vessel reconstructions. In: European Journal of Radiology. 2006 ; Vol. 57, No. 3. pp. 345-350.
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abstract = "Background: Sixteen-slice multi-detector computed tomography (MDCT) permits reliable noninvasive detection of significant coronary stenosis based on qualitative visual assessment. The purpose of this study was to determine the accuracy of MDCT to quantify the degree of coronary stenosis as compared to quantitative coronary angiography (QCA) using two different reconstruction methods. Methods: We studied 69 coronary artery lesions from 38 consecutive patients that underwent 16-slice MDCT as a part of research study, which enrolled consecutive subjects scheduled for clinically indicated invasive coronary angiography. Nine coronary artery lesions with motion artifacts, heavily calcified plaques or stents were excluded from the analysis. The degree of stenosis was calculated by two independent readers non-blinded to the location of the stenosis, but blinded to the results of the QCA. MDCT luminal diameters were measured in cross-sectional multi-planar reformatted (CS-MPR) images created perpendicular to the centerline of the vessel and in 5 mm thin-slab maximum intensity projections (MIP) parallel to the long axis of the vessel. Both MDCT methods were compared against QCA. Results: The mean degree of stenosis as measured by MDCT was closely correlated to QCA for both methods (CS-MPR versus QCA: 61 ± 23{\%} versus 64 ± 29{\%}; r2 = 0.83, p <0.001and MIP versus QCA: 64 ± 22{\%} versus 64 ± 29{\%}; r2 = 0.84, p <0.001for MIP. Bland-Altman analysis demonstrated a negative bias of the degree of stenosis of -2.8 ± 12{\%} using CS-MPR and a minimally positive bias of 0.6 ± 12{\%} for MIP. In stratified analysis for lesion severity (mild, 0-40{\%}; moderate, 41-70{\%} or severe, >70{\%}) the agreement between both CS-MPR and MIP was high when compared to QCA (κ = 0.74 and 0.71, respectively). Conclusion: Multi-detector spiral CT permits accurate quantitative assessment of the degree of coronary stenosis in selected data sets of sufficient quality using both cross-sectional and longitudinal vessel reconstructions.",
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T1 - Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis

T2 - Assessment of cross-sectional and longitudinal vessel reconstructions

AU - Cury, Ricardo C.

AU - Ferencik, Maros

AU - Achenbach, Stephan

AU - Pomerantsev, Eugene

AU - Nieman, Koen

AU - Moselewski, Fabian

AU - Abbara, Suhny

AU - Jang, Ik Kyung

AU - Brady, Thomas J.

AU - Hoffmann, Udo

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N2 - Background: Sixteen-slice multi-detector computed tomography (MDCT) permits reliable noninvasive detection of significant coronary stenosis based on qualitative visual assessment. The purpose of this study was to determine the accuracy of MDCT to quantify the degree of coronary stenosis as compared to quantitative coronary angiography (QCA) using two different reconstruction methods. Methods: We studied 69 coronary artery lesions from 38 consecutive patients that underwent 16-slice MDCT as a part of research study, which enrolled consecutive subjects scheduled for clinically indicated invasive coronary angiography. Nine coronary artery lesions with motion artifacts, heavily calcified plaques or stents were excluded from the analysis. The degree of stenosis was calculated by two independent readers non-blinded to the location of the stenosis, but blinded to the results of the QCA. MDCT luminal diameters were measured in cross-sectional multi-planar reformatted (CS-MPR) images created perpendicular to the centerline of the vessel and in 5 mm thin-slab maximum intensity projections (MIP) parallel to the long axis of the vessel. Both MDCT methods were compared against QCA. Results: The mean degree of stenosis as measured by MDCT was closely correlated to QCA for both methods (CS-MPR versus QCA: 61 ± 23% versus 64 ± 29%; r2 = 0.83, p <0.001and MIP versus QCA: 64 ± 22% versus 64 ± 29%; r2 = 0.84, p <0.001for MIP. Bland-Altman analysis demonstrated a negative bias of the degree of stenosis of -2.8 ± 12% using CS-MPR and a minimally positive bias of 0.6 ± 12% for MIP. In stratified analysis for lesion severity (mild, 0-40%; moderate, 41-70% or severe, >70%) the agreement between both CS-MPR and MIP was high when compared to QCA (κ = 0.74 and 0.71, respectively). Conclusion: Multi-detector spiral CT permits accurate quantitative assessment of the degree of coronary stenosis in selected data sets of sufficient quality using both cross-sectional and longitudinal vessel reconstructions.

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KW - Atherosclerosis

KW - Computed tomography

KW - Coronary artery disease

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