Diagnostic Performance of Multidetector CT Angiography for Assessment of Coronary Artery Disease: Meta-analysis

Abstract

With the newer generations of multidetector CT scanners, the diagnostic performance for the assessment of coronary artery disease has significantly improved, and the proportion of nonassessable segments has decreased.

Decision Analytic Model for Evaluation of Suspected Coronary Disease with Stress Testing and Coronary CT Angiography

“…14 Finally, because cCTA is a rapidly improving technology, we performed an additional analysis based upon the higher values of sensitivity/specificity reported in recent meta analyses of single center studies. 3,4 When interpreting a stress test or cCTA, results are often presented on a spectrum that extends from a truly negative test to a grossly positive test. Clearly, a stress MPS study that demonstrates an ECG abnormality along with a large reversible perfusion defect is more definitive than a study that demonstrates only a small fixed perfusion deficit.…”

“…Finally, although single center trials may overestimate the accuracy of a diagnostic study, several recent meta analyses of single center studies have suggested higher diagnostic accuracy than the multicenter trials referenced above. 3,4 Therefore, higher values of sensitivity and specificity were also tested based upon the analysis of Vanhoenacker. 3 Effective radiation dose for stress MPS, cCTA and diagnostic cardiac catheterization is a moving target with improvements in technology.…”

“…2 Coronary computed tomographic angiography (cCTA) provides a noninvasive alternative to cardiac catheterization for visualization of coronary anatomy, and has demonstrated high sensitivity and specificity for the anatomic presence of CAD. 3,4 Although functional information about wall motion can be obtained during cCTA, the primary utility of cCTA is for imaging of the coronary arteries to define the presence of CAD. Stress testing provides additional information to predict the functional relevance of coronary stenosis with respect to myocardial ischemia.…”

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses

“…Nevertheless, CCA is invasive and cannot be recommended as the sole diagnostic test, especially in patients with low-to-intermediate probability for CAD. For these patients, coronary computed tomography angiography (CCTA) is a highly accurate diagnostic alternative, with regards to its correlation with CCA and its high negative predictive value to exclude C50 % stenosis [2,3]. Meanwhile, to determine the likelihood for lesions' functional significance, the use of a discrete threshold lacks sensitivity, specificity or both [4,5].…”

Escore de cálcio e angiotomografia coronariana na estratificação do risco cardiovascular

“…There are some systematic reviews assessing the diagnostic value of CCTA since the advent of 64-row devices in 2004 [27][28][29][30] . In general, those studies have shown an improvement in the diagnostic accuracy of the method with the technology evolution from 4-and 16-row devices to current 64-row devices.…”