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High diagnostic accuracy of prospective ECG-gating 64-slice computed tomography coronary angiography for the detection of in-stent restenosis

In-stent restenosis assessment by low-dose MDCT

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The accuracy of computed tomography (CT) for assessment of coronary stents is as yet unproven and radiation exposure has been a concern. The aim of our study is to compare radiation dose and diagnostic performance of CT with prospective ECG-triggering versus retrospective ECG-triggering for the detection of in-stent restenosis (ISR).

Methods

We enrolled 168 consecutive patients with suspected ISR, 83 studied using CT with prospective ECG-triggering (group 1) and 85 using retrospective ECG-triggering (group 2).

Results

Prevalence of ISR according to catheter angiography was 24% in both groups. The overall evaluability was similar (93% in group 1 vs 95% in group 2). Artefact sub-analysis showed a significantly lower number of blooming and higher number of slice misalignment in group 1 vs group 2. In the stent-based analysis using only evaluable stents, specificity, positive predictive value and accuracy were significantly higher in group 1 (100%, 100% and 99%, respectively) than in group 2 (97%, 91% and 95%, respectively, p < 0.05). Group 1 was exposed to a lower radiation dose compared with group 2 (4.3 ± 1.4 mSv vs 18.5 ± 5.5 mSv, p < 00.1).

Conclusions

CT with prospective ECG-triggering can improve diagnostic accuracy of non-invasive imaging of coronary stents with a significant reduction in radiation exposure

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Authors and Affiliations

  1. Centro Cardiologico Monzino, IRCCS, Milan, Italy

    Daniele Andreini, Gianluca Pontone, Antonio L. Bartorelli, Saima Mushtaq, Daniela Trabattoni, Erika Bertella, Sarah Cortinovis, Andrea Annoni, Alberto Formenti, Giovanni Ballerini, Piergiuseppe Agostoni, Cesare Fiorentini & Mauro Pepi

  2. Department of Cardiovascular Sciences, University of Milan, Milan, Italy

    Piergiuseppe Agostoni & Cesare Fiorentini

Authors
  1. Daniele Andreini
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  2. Gianluca Pontone
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  3. Antonio L. Bartorelli
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  4. Saima Mushtaq
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  5. Daniela Trabattoni
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  6. Erika Bertella
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  7. Sarah Cortinovis
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  8. Andrea Annoni
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  9. Alberto Formenti
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  10. Giovanni Ballerini
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  11. Piergiuseppe Agostoni
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  12. Cesare Fiorentini
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  13. Mauro Pepi
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Corresponding author

Correspondence to Daniele Andreini.

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I assure that no relationship with industry and no competing interests exist.

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Andreini, D., Pontone, G., Bartorelli, A.L. et al. High diagnostic accuracy of prospective ECG-gating 64-slice computed tomography coronary angiography for the detection of in-stent restenosis. Eur Radiol 21, 1430–1438 (2011). https://doi.org/10.1007/s00330-011-2085-7

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  • DOI: https://doi.org/10.1007/s00330-011-2085-7

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