, Volume 27, Issue 7, pp 1045-1047

From stenosis imaging to functional imaging: a new horizon of coronary computed tomography

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Recent developments in coronary computed tomography angiography (CCTA) technology including improvements in temporal and spatial resolution, volume coverage, and software refinements has made it practical to use CCTA in clincal practice. Three multicenter studies and pooled analyses showed the diagnostic performance of 64-slice detector CCTA with sensitivity and specificity ranging from 85 to 99% and 74 to 96%, respectively [13]. Moreover, not only the severity of stenosis but also the extent of plaque burden evaluated by CCTA has been shown to identify future risk of cardiovascular events or all-cause death [4].

Current CCTA has very high negative predictive power. The false-negative rate is extremely low if CCTA shows no stenosis or minimal plaque. However, CCTA is limited by moderate positive predictive power for the detection of myocardial ischemia. It is not unexpected because the diameter stenosis is a poor indicator of myocardial ischemia, even by invasive coronary angiography (

Editorial comment on to the article of Lackner et al. (doi:10.1007/s10554-010-9728-7).