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Imaging coronary and extracoronary atherosclerosis: feasibility and impact of whole-body computed tomography angiography

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Abstract

A comprehensive whole-body approach to noninvasive evaluation of coronary and extracoronary vasculature is currently not available. The objective of our study was to assess the potential of 64-slice computed tomography angiography (64-CTA) for whole-body evaluation of atherosclerosis burden. Seventy-eight patients referred for coronary imaging underwent whole-body 64-CTA using an adjusted strategy for the administration of contrast medium with dose-saving algorithms involving ECG modulation and reduced tube voltage. Arterial segments (15 coronary, 32 systemic) were evaluated for significant (≥50%) steno-occlusive disease while arterovenous density was evaluated at seven extracoronary locations. Homogeneous attenuation (mean 321 ± 20 HU) was obtained throughout the systemic vasculature. Atherosclerosis was observed in 238/995 (24%) coronary and 368/2441 (15%) systemic segments. Significant stenoses/occlusions were present in 214 (21%)/24 (2.5%) coronary segments while asymptomatic clinically relevant stenoses were present in 49 systemic segments. Sensitivity, specificity, positive and negative predictive values of coronary 64-CTA among 52 patients who also underwent quantitative coronary angiography were 92%, 95%, 81% and 98%, respectively. ECG modulation decreased radiation exposure to 14.1–15.4 mSv per patient. Comprehensive, noninvasive assessment of atherosclerosis can be performed by whole-body 64-CTA and may have a positive impact on secondary prevention.

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Authors and Affiliations

  1. Cardiovascular Imaging Unit, Department of Radiological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Alessandro Napoli, Carlo Catalano, Marco Francone, Iacopo Carbone, Michele Anzidei, Francesca Antonella Calabrese, Beatrice Cavallo Marincola & Roberto Passariello

  2. Department of Surgery, “P. Valdoni”, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Vincenzo Sciacca

  3. Department of Heart and Great Vessels, University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Cesare Greco

  4. Worldwide Medical and Regulatory Affairs, Bracco Imaging SpA, Milan, Italy

    Miles A. Kirchin

  5. Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Annarita Vestri

  6. Department of Medical Therapy, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Marcello Arca

  7. Department of Internal Medicine and Unit of Vascular Medicine, Polo Pontino, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy

    Luigi Iuliano

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  1. Alessandro Napoli
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  2. Carlo Catalano
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  3. Marco Francone
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  14. Roberto Passariello
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Correspondence to Alessandro Napoli.

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Napoli, A., Catalano, C., Francone, M. et al. Imaging coronary and extracoronary atherosclerosis: feasibility and impact of whole-body computed tomography angiography. Eur Radiol 19, 1704–1714 (2009). https://doi.org/10.1007/s00330-009-1342-5

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  • DOI: https://doi.org/10.1007/s00330-009-1342-5

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