Cardiac CT can effectively assess coronary artery disease

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Cardiac CT can accurately identify coronary artery stenosis, according to a study in the December issue of the American Journal of Roentgenology.

The study consisted of 1,331 patients who had suspected coronary artery disease with 50 percent or more stenosis, and analyzed 10,561 coronary artery segments.

“We found a 98 percent sensitivity rate for detecting significant coronary artery stenosis in our patients; specificity was 91 percent,” according to the study’s lead authors Lucia J.M. Kroft, MD, and Alexander Meijer, MSc, from the department of radiology at Leiden University Medical Center in Leiden, the Netherlands.  

If non-evaluable multi-detector CT investigations were included, the researchers found that per-patient specificity was reduced from 91 to 89.1 percent when allocating excluded patients as having significant coronary artery stenosis, and the sensitivity was reduced from 97.7 to 96.2 percent when allocating excluded patients as not having significant stenosis. The per-patient prevalence of coronary artery stenosis had no significant influence on the sensitivity for detecting significant stenosis.

“The results indicate that in patients with an intermediate clinical probability of coronary artery disease, cardiac CT scans may avoid the use of invasive catheter angiography. Catheter-based angiography is currently the gold standard for coronary artery evaluation, but it is an invasive technique, has a small percentage of "major" complications and it is relatively expensive,” Kroft and Meijer said.

“Radiologists, cardiologists, their patients, medical policy makers and financial controllers all have a stake in learning about the accuracy and usefulness of computer generated images of the heart,” Kroft said.

“Multi-slice CT is increasingly being used as a daily practice in the evaluation of these patients and yet, up until now, its efficacy has not been proven. Our study has made a contribution to that direction” Meijer said.