Improved evaluability and accuracy was seen with high spatial resolution in comparison with standard spatial resolution coronary CT angiography of calcified coronary artery lesions, according to a study published online Feb. 8 by Radiology.
Lead author Gianluca Pontone, MD, of the Centro Cardiologico Monzino in Milan, Italy, and colleagues compared the image quality, evaluability, diagnostic accuracy, and radiation exposure of high spatial coronary CT angiography with those of CT angiography with a standard spatial resolution in patients at high risk for coronary artery disease (CAD) by using invasive coronary angiography as the reference method.
The study included 197 consecutive patients who were at high risk for CAD and scheduled for an invasive coronary angiography. These participants were randomized to undergo standard or high spatial resolution coronary CT angiography and were examined with invasive coronary angiography within a week after the imaging.
Results revealed that high spatial resolution coronary CT angiography had a higher image quality score than the standard, with a score of 3.7 versus 3.4. The evaluability of the high spatial resolution was also higher at 97 percent versus 92 percent. High spatial resolution coronary CT angiography also had a higher specificity, positive predictive value, and accuracy. Importantly, it demonstrated a better agreement with invasive coronary angiography for calcified plaques than standard spatial resolution coronary CT angiography.
“Patients at high risk of coronary artery disease, who are more likely to have multiple calcified plaques and a risk of overestimation of stenosis secondary to blooming from calcification, may benefit from this technology,” concluded Pontone and colleagues.
The study’s authors suggest the need to conduct further research in order to compare the technology with other technological approaches that reduce artifacts related to calcified plaques.