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Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality

  • Cardiac
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Abstract

Objectives

To investigate the diagnostic performance of low dose stent imaging in patients with large (≥ 3 mm) and small (< 3 mm) calibre stents by third-generation dual-source CT.

Methods

Symptomatic patients suspected of having in-stent restenosis (ISR) were prospectively enrolled. Coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) were performed within 1 month for correlation. Binary ISR was defined as an in-stent neointimal proliferation with diameter stenosis ≥ 50%. The radiation dose and image quality of CCTA were also assessed.

Results

Sixty-nine patients with 140 stents were ultimately included for analysis. The mean total radiation dose of CCTA was 1.3 ± 0.72 mSv in all patients and 0.95 ± 0.17 mSv in patients with high pitch acquisition. The overall diagnostic accuracy of CCTA stent imaging of patient-based, lesion-based and stent-based analysis was 95.7%, 94.1% and 94.3%, respectively. Further, the diagnostic accuracy of CCTA in the small calibre stent group (diameter < 3 mm) was slightly lower than that of the large calibre stent group (diameter ≥ 3 mm) (88.5% versus 98.7%, p = 0.01).

Conclusions

Third-generation dual-source CT enables accurate diagnosis of coronary ISR of both large and small calibre stents. Low radiation dose could be achieved with preserved image quality.

Key Points

• Third-generation DSCT enables accurate diagnosis of coronary ISR of all size stents.

• Low radiation dose could be achieved with preserved image quality.

• The diagnostic accuracy of CCTA of small calibre stents was 88.5%.

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Abbreviations

CCTA:

Coronary computed tomography angiography

ICA:

Invasive coronary angiography

ISR:

In-stent restenosis

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Funding

This study has received funding by National Natural Science Foundation of China (Grant No.: 81671678, 81671673) and Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (Grant No.: 20161428).

Author information

Author notes

  1. Dr. Yuehua Li and Dr. Mengmeng Yu contributed equally to this study.

Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, #600, Yishan Rd, Shanghai, 200233, China

    Yuehua Li, Mengmeng Yu, Wenbin Li & Jiayin Zhang

  2. Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, #600, Yishan Rd, Shanghai, China

    Zhigang Lu & Meng Wei

Authors
  1. Yuehua Li
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  2. Mengmeng Yu
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  3. Wenbin Li
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  4. Zhigang Lu
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  5. Meng Wei
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  6. Jiayin Zhang
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Corresponding author

Correspondence to Jiayin Zhang.

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Guarantor

The scientific guarantor of this publication is Dr. Jiayin Zhang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was obtained from all patients.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

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Li, Y., Yu, M., Li, W. et al. Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality. Eur Radiol 28, 2647–2654 (2018). https://doi.org/10.1007/s00330-017-5256-3

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  • DOI: https://doi.org/10.1007/s00330-017-5256-3

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