Dual-Source CT IDs Heart Disease in Hard-to-Image Patients
(HealthDay News) – In patients who have previously been considered difficult to image, dual-source cardiac (DSC) computed tomography (CT) can identify clinically significant coronary artery disease, according to a review published in the May issue of Radiology.
Marie E. Westwood, PhD, from Kleijnen Systematic Reviews in York, UK, and colleagues conducted a literature review to evaluate the diagnostic performance of DSC CT newer-generation instruments for identifying coronary artery disease in patients who are difficult to image using 64-section CT. Twenty-five studies were included which used invasive coronary angiography as reference standard.
Of the 22 studies that used a Somatom Definition instrument, the researchers found that the pooled, per-patient estimates of sensitivity were 97.7% for patients with arrhythmias and 97.7% for patients with high heart rates. For specificity, the corresponding pooled estimates were 81.7% and 86.3%. For patients with previous stent implantations, sensitivity estimates of ≥90% were reported in two studies with Somatom and one study with Aquilion One, while specificities were 81.7% and 89.5% for Somatom and 81% for Aquilion One. Only per-segment or per-artery data were available in patients with high coronary calcium scores, previous bypass grafts, or obesity, but sensitivity estimates remained high (>90% in all but one study) and specificities ranged from 79.1–100% using Somatom Definition.
"DSC CT may provide sufficiently accurate anatomic information for the diagnosis and assessment of coronary artery disease in some or all difficult to image groups; these technologies may be most useful in avoiding further invasive investigations," the authors write.
One author disclosed financial ties to Kleijnen Systematic Reviews.