European Radiology

, Volume 18, Issue 2, pp 217–225

Diagnostic accuracy of in-stent coronary restenosis detection with multislice spiral computed tomography: a meta-analysis

  • Michèle Hamon
  • Laure Champ-Rigot
  • Rémy Morello
  • John W. Riddell
  • Martial Hamon
Cardiac

Abstract

This study was designed to define the current role of multislice spiral computed tomography (MSCT) for the diagnosis of coronary in-stent restenosis using a meta-analytic process. Restenosis remains a limitation after coronary stent implantation and contributes to a substantial number of coronary re-assessments by conventional invasive coronary angiography (CA). We identified 15 studies (807 patients) evaluating in-stent restenosis by means of both MSCT (≥16 slices) and conventional CA until February 2007. After data extraction the analysis was performed according to a random-effects model. The analysis pooled the results from 15 studies with a total of 1,175 stents. A substantial number of unassessable stents (13%) were excluded from the analysis underscoring the shortcomings of MSCT. With this major limitation the diagnostic performance of MSCT for in-stent restenosis detection can be summarized as follows: the sensitivity and specificity were 84% [95% confidence interval (CI) 77–89%] and 91% (95% CI 89–93%), respectively, with positive and negative likelihood ratios of 12.2 (95% CI 6.6–22.6) and 0.23 (95% CI 0.17–0.31), respectively, and with a diagnostic odds ratio of 67.9 (95% CI 34.4–134.1). MSCT has shortcomings difficult to overcome in daily practice for in-stent restenosis detection and continues to have moderately high sensitivity and specificity. The diagnostic role of this emerging technology as an alternative to CA for in-stent restenosis detection remains limited.

Keywords

MSCT Computed tomography Restenosis Stent Invasive angiography Coronary angiography Meta-analysis 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Michèle Hamon
    • 1
  • Laure Champ-Rigot
    • 2
  • Rémy Morello
    • 3
  • John W. Riddell
    • 2
  • Martial Hamon
    • 2
    • 4
    • 5
  1. 1.Department of RadiologyUniversity Hospital of Caen14033 Caen CedexFrance
  2. 2.Department of CardiologyUniversity Hospital of Caen14033 Caen CedexFrance
  3. 3.Department of StatisticsUniversity Hospital of Caen14033 Caen CedexFrance
  4. 4.INSERM 744Institut Pasteur de LilleLilleFrance
  5. 5.Service des Maladies du Coeur et des VaisseauxCentre Hospitalier Universitaire de Caen14033 Caen CedexFrance

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