News | December 16, 2009

CT Calcium Detection Aids in Ruling Out Obstructive Coronary Disease

Stock image

December 16, 2009 - Non-enhanced CT for calcium detection is a reliable way to exclude obstructive coronary artery disease in patients with chest pain, according to a study published in the December issue of the American Journal of Cardiology. While is a well established option for , particularly when stress tests are inconclusive or not feasible, Concerns surrounding radiation and contrast exposure prompted researchers, led by Dr. Koen Nieman and colleagues from Erasmus Medical Center, Rotterdam, The Netherlands, to investigate alternative diagnostic techniques for evaluating patients with chest pain other than CT angiography (CTA). To compare the effectiveness of coronary calcium scores (CCS), CTA, and exercise electrocardiography (XECG) for detecting obstructive coronary disease, researchers evaluated 471 patients with new stable chest pain. In eight patients (1.7 percent), neither CCS nor CTA was possible. In an additional eight, CTA could not be performed for various reasons. All of the calcium scans were successful, while three CTAs failed. XECG was not possible in 48 patients (10.2 percent) and was inconclusive in 140 of 423 patients (33 percent). Ninety-eight patients underwent catheter angiography, with 57 found to have at least 50 percent diameter obstruction. Overall, 175 patients (37 percent) had a negative CCS. Three of these (2 percent) had significant CAD on CT angiograms, only one of which was confirmed by quantitative angiography. In patients with a high CCS (Agatston of more than 400; n = 65), CTA could exclude obstructive CAD in no more than four (6 percent). CT was more often diagnostic in patients with a low-intermediate CCS (10 to 400; n = 175), and could rule out obstructive CAD in 56 percent of patients. Few cases of obstructive disease were detected in patients with a low CCS (less than 10; n = 48), although these patients had evidence of atherosclerotic disease. Overall, 42 percent of patients had positive CT angiograms. These patients had significant stenosis on quantitative angiogram more often when exercise electrocardiogram was also positive. For patients with diagnostic results for all tests, the sensitivity and specificity to detect significant coronary stenosis were 100 percent and 16 percent for CCS of more than zero, 82 percent and 64 percent for CCS of more than 100, 97 percent and 36 percent for CTA, and 70 percent and 76 percent for XECG, respectively. The type of tests preferred for the workup of suspected CAD - functional, or anatomical - is still up for debate. "Although XECG is considered more cost effective, it has poor diagnostic performance," the researchers noted. The researchers concluded, similar to a negative stress test result, a negative CCS also has an excellent prognosis. This suggests that a negative CCS could suffice to rule out obstructive CAD without the need for further testing. For more information:www.ajconline.org

Related Content

Canon Aquilion One CT Helps Gates Vascular Institute Adhere to New Stroke Guidelines
News | Computed Tomography (CT) | December 12, 2018
In stroke, time saved on imaging is time gained in the treatment window. The recently updated guidelines from the...
Coreline Soft Introduces AI Lung Segmentation Solution at RSNA 2018
News | Lung Cancer | December 10, 2018
December 10, 2018 — Korean image software company Coreline Soft Co. Ltd.
FDA Approves New Features for Planmed Verity Cone Beam CT Scanner
Technology | Computed Tomography (CT) | December 07, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the new features and intended uses of the...
YITU Releases AI-Based Cancer Screening Solutions at RSNA 2018
News | Artificial Intelligence | December 06, 2018
Chinese artificial intelligence (AI) healthcare company YITU healthcare released two brand-new products, Intelligent...
Guerbet Launches Multi-Use OptiVantage Contrast Media Injector in Europe
Technology | Contrast Media Injectors | December 05, 2018
Contrast agent company Guerbet recently announced that the OptiVantage multi-use contrast media injector is now CE...
GE Healthcare Unveils New Applications and Smart Devices Built on Edison Platform
Technology | Artificial Intelligence | December 05, 2018
GE Healthcare recently announced new applications and smart devices built on Edison – a platform that helps accelerate...
Infervision Introduces AI Capabilities for Chest CT Reading
Technology | Computer-Aided Detection Software | November 30, 2018
Big data and artificial intelligence (AI) company Infervision announced the launch of InferRead CT Chest, a new product...
NeuroLogica and MaxQ AI Announce Distribution Agreement
News | Stroke | November 30, 2018
Clinical diagnostics intelligence platform company MaxQ AI and Samsung NeuroLogica announced a distribution agreement...
Videos | Advanced Visualization | November 30, 2018
This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at t