European Radiology

, Volume 24, Issue 1, pp 3–11 | Cite as

Diagnostic accuracy of low-dose 256-slice multi-detector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease

  • Yang Hou
  • Yue Ma
  • Weipeng Fan
  • Yuke Wang
  • Mei Yu
  • Mani Vembar
  • Qiyong Guo



To evaluate the accuracy of low-dose coronary CTA with iterative reconstruction (IR) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD.


Ninety-six patients with suspected CAD underwent low-dose prospective electrocardiogram-gated coronary CTA, with images reconstructed using IR. Image quality (IQ) of coronary segments were graded on a 4-point scale (4, excellent; 1, non-diagnostic). With invasive coronary angiography (ICA) considered the “gold standard”, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of coronary CTA were calculated on segment-, vessel- and patient-based levels. The patient data were divided into two groups (Agatston scores of ≥ 400 and <400). The differences in diagnostic performance between the two groups were tested.


Diagnostic image quality was found in 98.1 % (1,232/1,256) of segments. The sensitivity, specificity, PPV, NPV and accuracy were 90.8 %, 95.3 %, 81.8 %, 97.8 % and 94.3 % (segment-based) and 97.2 %, 83.3 %, 94.6 %, 90.9 % and 93.8 % (patient-based). Significant differences between the two groups were seen in specificity, PPV and accuracy (92.1 % vs. 97.9 %, 76.0 % vs. 86.7 %, 91.7 % vs. 96.6 %, P < 0.05; segment-based). The average effective dose was 1.30 ± 0.15 mSv.


Low-dose prospective coronary CTA with IR can acquire satisfactory image quality and show high diagnostic accuracy in patients with suspected CAD; however, blooming continues to pose a challenge in severely calcified segments.

Key Points

• Coronary artery disease (CAD) is increasingly investigated using coronary CTA.

• The iterative reconstruction (IR) algorithm is promising in decreasing radiation doses.

• Low-dose prospective coronary CTA with IR can acquire satisfactory image quality.

• Low-dose prospective coronary CTA with IR can show high diagnostic accuracy.


Iterative reconstruction Tomography X-ray computed Coronary angiography Radiation dosage Coronary artery disease 



The work presented was supported by government funding through the Shenyang Science and Technology Research Program (F12-193-9-35).


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Yang Hou
    • 1
  • Yue Ma
    • 1
  • Weipeng Fan
    • 2
  • Yuke Wang
    • 1
  • Mei Yu
    • 1
  • Mani Vembar
    • 3
  • Qiyong Guo
    • 1
  1. 1.Department of RadiologyShengjing Hospital of China Medical UniversityShenyangChina
  2. 2.Department of RadiologyCentral Hospital of AnshanAnshanChina
  3. 3.CT Clinical Science Philips HealthcareClevelandUSA

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