Purpose:To compare accuracy and radiation exposure of a new computed tomographic (CT) scanner with improved spatial resolution (scanner A) with those of a CT scanner with standard spatial resolution (scanner B) for evaluation of coronary in-stent restenosis (ISR) by using invasive coronary angiography (ICA) and intravascular ultrasonography (US) as reference methods.Materials and Methods:Written informed consent was obtained and study protocol was approved by institutional ethics committee. A total of 180 consecutive patients (154 men [mean age ± standard deviation, 66 years ± 12; range, 51-79 years] and 36 women [mean age, 70 years ± 12; range, 55-83 years]) scheduled to undergo ICA for suspected ISR were enrolled. Ninety patients were studied with scanner A (group 1: 72 men [mean age, 65 years ± 11; range, 52-79], 18 women [mean age, 68 years ± 12; range, 55-83 years]) and 90 with scanner B (group 2: 74 men [mean age, 64 years ± 10; range, 51-77 years], 16 women [mean age, 68 years ± 11; range, 55-82 years). Examination with the two scanners was compared with ICA and intravascular US. Radiation dose exposure was estimated. To compare stent evaluability between the two groups, χ(2) test was used.Results:Stent evaluability was higher in group 1 than in group 2 (99% vs 92%, P = .0021). A significantly lower rate of beam-hardening artifact was observed in group 1 (two cases) than group 2 (12 cases, P <.05). For stent-based analysis, sensitivity, specificity, and accuracy of multidetector CT for ISR identification were 96%, 95%, and 96% in group 1 and 90%, 91%, and 91% in group 2, respectively, without statistically significant differences. The correlation between percent ISR evaluated at multidetector CT versus intravascular US was higher in group 1 than in group 2 (r = 0.89 vs r = 0.58; P = .019). The correlations of diameter and area measurements at reference site and stent maximal lumen narrowing site between multidetector CT and intravascular US were higher in group 1 than in group 2. Radiation dose was low in both multidetector CT groups (1.9 mSv ± 0.2).Conclusion:Scanner A, with improved spatial resolution, allowed reliable detection and quantification of coronary ISR with low radiation exposure.© RSNA, 2012Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112363/-/DC1

Coronary In-Stent Restenosis : Assessment with CT Coronary Angiography / D. Andreini, G. Pontone, S. Mushtaq, A.L. Bartorelli, E. Bertella, D. Trabattoni, P. Montorsi, S. Galli, C. Foti, A. Annoni, F. Bovis, G. Ballerini, P. Agostoni, C. Fiorentini, M. Pepi. - In: RADIOLOGY. - ISSN 0033-8419. - 265:2(2012 Nov), pp. 410-417. [10.1148/radiol.12112363]

Coronary In-Stent Restenosis : Assessment with CT Coronary Angiography

D. Andreini;G. Pontone;S. Mushtaq;A.L. Bartorelli;E. Bertella;P. Montorsi;A. Annoni;P. Agostoni;C. Fiorentini;
2012

Abstract

Purpose:To compare accuracy and radiation exposure of a new computed tomographic (CT) scanner with improved spatial resolution (scanner A) with those of a CT scanner with standard spatial resolution (scanner B) for evaluation of coronary in-stent restenosis (ISR) by using invasive coronary angiography (ICA) and intravascular ultrasonography (US) as reference methods.Materials and Methods:Written informed consent was obtained and study protocol was approved by institutional ethics committee. A total of 180 consecutive patients (154 men [mean age ± standard deviation, 66 years ± 12; range, 51-79 years] and 36 women [mean age, 70 years ± 12; range, 55-83 years]) scheduled to undergo ICA for suspected ISR were enrolled. Ninety patients were studied with scanner A (group 1: 72 men [mean age, 65 years ± 11; range, 52-79], 18 women [mean age, 68 years ± 12; range, 55-83 years]) and 90 with scanner B (group 2: 74 men [mean age, 64 years ± 10; range, 51-77 years], 16 women [mean age, 68 years ± 11; range, 55-82 years). Examination with the two scanners was compared with ICA and intravascular US. Radiation dose exposure was estimated. To compare stent evaluability between the two groups, χ(2) test was used.Results:Stent evaluability was higher in group 1 than in group 2 (99% vs 92%, P = .0021). A significantly lower rate of beam-hardening artifact was observed in group 1 (two cases) than group 2 (12 cases, P <.05). For stent-based analysis, sensitivity, specificity, and accuracy of multidetector CT for ISR identification were 96%, 95%, and 96% in group 1 and 90%, 91%, and 91% in group 2, respectively, without statistically significant differences. The correlation between percent ISR evaluated at multidetector CT versus intravascular US was higher in group 1 than in group 2 (r = 0.89 vs r = 0.58; P = .019). The correlations of diameter and area measurements at reference site and stent maximal lumen narrowing site between multidetector CT and intravascular US were higher in group 1 than in group 2. Radiation dose was low in both multidetector CT groups (1.9 mSv ± 0.2).Conclusion:Scanner A, with improved spatial resolution, allowed reliable detection and quantification of coronary ISR with low radiation exposure.© RSNA, 2012Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112363/-/DC1
multidetector computed-tomography ; diagnostic-accuracy ; vitro evaluation ; image quality ; experience ; sensitivity and specificity ; reproducibility of results ; coronary angiography ; humans ; tomography, X-ray computed ; aged ; coronary restenosis ; graft occlusion, vascular ; radiographic image enhancement ; middle aged ; stents ; female ; male
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
nov-2012
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/204710
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