Diagnostic accuracy of coronary CT angiography using 3rd-generation dual-source CT and automated tube voltage selection: Clinical application in a non-obese and obese patient population
To investigate diagnostic accuracy of 3rd-generation dual-source CT (DSCT) coronary angiography in obese and non-obese patients.
We retrospectively analyzed 76 patients who underwent coronary CT angiography (CCTA) and invasive coronary angiography. Prospectively ECG-triggered acquisition was performed with automated tube voltage selection (ATVS). Patients were dichotomized based on body mass index in groups A (<30 kg/m2, n = 37) and B (≥30 kg/m2, n = 39) and based on tube voltage in groups C (<120 kV, n = 46) and D (120 kV, n = 30). Coronary arteries were assessed for significant stenoses (≥50 % luminal narrowing) and diagnostic accuracy was calculated.
Per-patient overall sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy were 96.9 %, 95.5 %, 93.9 %, 97.7 % and 96.1 %, respectively. Sensitivity and NPV were lower in groups B and D compared to groups A and C, but no statistically significant differences were observed (group A vs. B: sensitivity, 100.0 % vs. 93.3 %, p = 0.9493; NPV, 100 % vs. 95.5 %, p = 0.9812; group C vs. D: sensitivity, 100.0 % vs. 92.3 %, p = 0.8462; NPV, 100.0 % vs. 94.1 %, p = 0.8285).
CCTA using 3rd-generation DSCT and (ATVS) provides high diagnostic accuracy in both non-obese and obese patients.
• Coronary CTA provides high diagnostic accuracy in non-obese and obese patients.
• Diagnostic accuracy between obese and non-obese patients showed no significant difference.
• <120 kV studies were performed in 44 % of obese patients.
• Current radiation dose-saving approaches can be applied independent of body habitus.
KeywordsCoronary CT angiography Dual-source CT Automated tube voltage selection Diagnostic accuracy Obesity
Coronary CT angiography
Invasive coronary angiography
Coronary artery disease
Positive predictive value
Automated tube voltage selection
Region of interest
Left anterior descending
Right coronary artery
Volume CT dose index
Size-specific dose estimates
Negative predictive value
The scientific guarantor of this publication is Prof. Dr. U. Joseph Schoepf.
The authors of this manuscript declare relationships with the following companies: Dr. Schoepf is a consultant for and receives research support from Astellas, Bayer, Bracco, GE, Medrad, and Siemens. Mr. Canstein is a Siemens employee. The other authors have no conflicts of interest to disclose.
The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained.
Written informed consent was waived by the Institutional Review Board. No study subjects or cohorts have been previously reported. Methodology: retrospective, cross sectional study, performed at one institution.
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