Abstract
This study evaluated the feasibility of stress 320 detector CT coronary angiography (CTA) derived transluminal attenuation gradient (TAG320) and contrast opacification (CO) difference to detect hemodynamically significant stenoses as determined by invasive fractional flow reserve (FFR ≤ 0.80). Twenty-seven patients, including 51 vessels on rest CTA were studied. 16 (31 %) vessels were not interpretable on stress CTA largely secondary to motion artefacts. Receiver operating characteristic curve analysis showed a comparable area under the curve (AUC) for rest and stress TAG320 (0.78 and 0.75) which was higher than CTA alone (0.68), and rest and stress CO difference (0.76 and 0.67). Compared with rest CTA, stress CTA demonstrated inferior image quality (Median Likert score 4 vs. 3, P < 0.0001) and required a higher mean radiation exposure (3.2 vs. 5.1 mSv, P < 0.0001). Stress TAG320 and CO difference is less feasible and was not superior in diagnostic performance when compared with rest TAG320 and CO difference.
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Abbreviations
- CAD:
-
Coronary artery disease
- FFR:
-
Fractional flow reserve
- CTA:
-
CT coronary angiography
- TAG320:
-
Transluminal attenuation gradient
- CO difference:
-
Contrast opacification difference
- PPV:
-
Positive predictive value
- NPV:
-
Negative predictive value
- ROC AUC:
-
Receiver operating characteristics area under curve
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Acknowledgments
Dr. Ko and Dr. Wong are funded by the National Heart Foundation of Australia and Robertson Family Scholarship.
Funding
DW & BK is supported by National Heart Foundation (Australia) Post-Doctoral-fellowships and Robertson-Family-Research-Cardiologist-Fund.
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Dr. Seneviratne has been an invited speaker at a Toshiba sponsored meeting. Professor Meredith has received honoraria for serving on strategic advisory boards of Boston Scientific and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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Ko, B.S., Seneviratne, S., Cameron, J.D. et al. Rest and stress transluminal attenuation gradient and contrast opacification difference for detection of hemodynamically significant stenoses in patients with suspected coronary artery disease. Int J Cardiovasc Imaging 32, 1131–1141 (2016). https://doi.org/10.1007/s10554-016-0867-3
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DOI: https://doi.org/10.1007/s10554-016-0867-3