Multislice computed tomography: angiographic emulation versus standard assessment for detection of coronary stenoses

Abstract

The present study investigated angiographic emulation of multislice computed tomography (MSCT) (catheter-like visualization) as an alternative approach of analyzing and visualizing findings in comparison with standard assessment. Thirty patients (120 coronary arteries) were randomly selected from 90 prospectively investigated patients with suspected coronary artery disease who underwent MSCT (16-slice scanner, 0.5 mm collimation, 400 ms rotation time) prior to conventional coronary angiography for comparison of both approaches. Sensitivity and specificity of angiographic emulation [81% (26/32) and 93% (82/88)] were not significantly different from those of standard assessment [88% (28/32) and 99% (87/88)], while the per-case analysis time was significantly shorter for angiographic emulation than for standard assessment (3.4 +/- 1.5 vs 7.0 +/- 2.5 min, P < 0.001). Both interventional and referring cardiologists preferred angiographic emulation over standard curved multiplanar reformations of MSCT coronary angiography for illustration, mainly because of improved overall lucidity and depiction of sidebranches (P < 0.001). In conclusion, angiographic emulation of MSCT reduces analysis time, yields a diagnostic accuracy comparable to that of standard assessment, and is preferred by cardiologists for visualization of results.

Indications, imaging technique, and reading of cardiac computed tomography: survey of clinical practice

“…43% (71/164) of the participants routinely used the phases [19], and cath views (12%, 20/169). The total average time required for interpretation and reporting was 28.7±17.8 min (median 20 min; range, 5-120 min).…”

Can segmented 3D images be used for stenosis evaluation in coronary CT angiography?

“…High sensitivity (98%) and NPV (99%) were reported from a pilot study (17). In ( 19), Schnapauff et al evaluated an "angiographic emulation" function of a commercial system (Vitrea 2, Version 3.5, Vital Images, Plymouth, MN, USA), in which "automatically detected centerline was used to create angiographic data of the left and right coronary artery tree" ( judging from the image in (19), the surrounding tissue were also presented in the 3D images with a different window setting). Even with data acquired from 16-slice CT scanner, acceptable accuracy (90% [108/120]) and NPV (94% [82/88]) were achieved.…”

Novel Techniques for Automatically Enhanced Visualization of Coronary Arteries in MSCT Data and for Drawing Direct Comparisons to Conventional Angiography

“…This 3D representation can be compared with the coronary tree extracted from the CT data. In (Schnapauff et al, 2007) emulation of conventional angiography is performed by segmenting the coronary arteries in the CT data and displaying the results by volume rendering techniques.…”