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

Hamon, M.; Champ‐Rigot, Laure; Morello, Rémy; Riddell, John W.; Hamon, Martial

doi:10.1007/s00330-007-0743-6

Cited by 64 publications

(33 citation statements)

References 34 publications

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“…In a meta-analysis of 15 studies, 1175 intracoronary stent were assessed with the 16 and 64-slice CT scanners, and the average sensitivity and specificity were reported as 84% and 91%, respectively (Hamon et al, 2008). In our study, 33% sensitivity of 16-slice CT angiography is below the sensitivities of other studies but 95% specificity level is comparable to other studies.…”

Section: Discussioncontrasting

confidence: 45%

Clinical usefulness of the 16-slice computed tomography coronary angiography for evaluation of early phase intracoronary stent patency

Yüksel¹,

Şahin²,

Elmalı³

et al. 2013

jecm

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Article HistoryReceived 02 / 08 / 2012 Accepted 30 / 08 / 2012Coronary artery stenting is currently treatment of choice for management of coronary artery disease. Stent restenosis is the most important problem during follow up. Conventional coronary angiography is the gold standart for assessment of intracoronary stent patency. It is an invasive method and even though rare, has some significant risks. For this reason, noninvasive imaging methods are necessary to evaluate stent patency. Noninvasive methods such as the exercise test, myocardial perfusion scintigraphy and stress echocardiography could not reach enough diagnostic accuracy. Multislice computed tomography (MSCT) has been under investigation for stent restenosis detection. Aim of this study is to investigate usefulness of the 16-slice CT for evaluation of stent patency in patients with suspicion of stent restenosis. Thirty six patients were included in the study and 16-slice CT and conventional coronary angiographies were performed in all patients. The results of 16-slice CT and conventional coronary angiography were compared. Sufficient or good quality imaging with 16-slice CT angiography was obtained in 69% of all patients. Sixteen-slice CT angiography detected 42/49 (86%) stents and gave the correct localization for all of the detected stents. Stent lumen could be assessed in 30 (61%) stents and according to the results of luminal assessment, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 16-slice MSCT were calculated as 33%, 95%, 75%, 77% and 77%, respectively. According to these results, the diagnostic performance of 16-slice CT angiography for detection of stent restenosis was relatively low. However, the assessment of relatively small number of stents because of insufficient heart rate control did not allow reliable and precise evaluation. Our results showed that diagnostic capacity of 16-slice CT angiography for detection of coronary stent restenosis is limited.

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Section: Discussioncontrasting

confidence: 45%

Clinical usefulness of the 16-slice computed tomography coronary angiography for evaluation of early phase intracoronary stent patency

Yüksel¹,

Şahin²,

Elmalı³

et al. 2013

jecm

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“…Routine follow-up angiography in these patients has not been recommended [1]. Previous studies suggest supporting the clinical indications for 64-slice coronary CTA as a gatekeeper for the exclusion of in-stent restenosis, owing to its high negative predictive value [2][3][4][5][6][7]. However, the substantial numbers of unassessable stents, up to 14% [3], limit the usefulness of this approach.…”

Section: Introductionmentioning

confidence: 98%

“…Factors affecting metal artifacts include stent material, stent diameter, strut thickness, and strut design. In fact, small stent diameter has been identified by several groups as a major factor in the failure of in-stent restenosis assessment, with a consensus that only stents with a diameter greater than 3 mm are routinely interpretable in coronary CTA [2]. Schuijf et al showed that images of 41% of stents with thick struts (0.14 mm or larger) were uninterpretable, as compared with images of 11% of stents with thinner struts [3].…”

Section: Introductionmentioning

confidence: 98%

Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

et al. 2009

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The purpose of this study was to compare coronary 64-slice CT angiography (CTA) protocols, specifically prospective electrocardiograph (ECG)-triggered and retrospective ECG-gated CT acquisition performed using a tube voltage of 140 kV and 120 kV, regarding intracoronary stent imaging. Coronary artery stents (n = 12) with artificial in-stent restenosis (50% luminal reduction, 40 HU) on a cardiac phantom were examined by CT at heart rates of 50-75 beats per minute (bpm). The subjective visibility of in-stent restenosis was evaluated with a three-point scale (1 clearly visible, 2 visible, and 3 not visible), and artificial lumen narrowing [(inner stent diameter - measured lumen diameter)/inner stent diameter], lumen attenuation increase ratio [(in-stent attenuation - coronary lumen attenuation)/coronary lumen attenuation], and signal-to-noise ratio of in-stent lumen were determined. The effective dose was estimated. The artificial lumen narrowing (mean 43%), the increase of lumen attenuation (mean 46%), and signal-to-noise ratio (mean 7.8) were not different between CT acquisitions (p = 0.12-0.91). However, the visibility scores of in-stent restenosis were different (p < 0.05) between ECG-gated CTA techniques: (a) 140-kV prospective (effective dose 4.6 mSv), 1.6; (b) 120-kV prospective (3.3 mSv), 1.8; (c) 140-kV retrospective (16.4-18.8 mSv), 1.9; and (d) 120-kV retrospective (11.0-13.4 mSv), 1.9. Thus, 140-kV prospective ECG-triggered CTA improves coronary in-stent restenosis visibility at a lower radiation dose compared with retrospective ECG-gated CTA.

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“…With increased number of slice such as 16-and 64-slice scanners, improved diagnostic accuracy has been reported in imaging of coronary artery disease and coronary stents [8-12, 17, 18]. This has been confirmed by a number of systematic reviews or meta-analyses of diagnostic accuracy of multislice CT angiography for detection of coronary in-stent restenosis [19][20][21][22]. It is evident from these reports that MSCT is increasingly playing an important role in the follow-up of patients treated with coronary stents and serves as an effective less-invasive technique.…”

Section: Discussionmentioning

confidence: 72%

Optimal scanning protocols of 64-slice CT angiography in coronary artery stents: An in vitro phantom study

Almutairi¹,

Sun²,

Ng³

et al. 2010

European Journal of Radiology

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Purpose: The purpose of the study was to investigate the optimal scanning protocol of 64-slice CT angiography for assessment of coronary artery stents based on a phantom study. Materials and Method:Coronary stents with a diameter of 2.5 mm was implanted in thin plastic tubes with an inner diameter of 3.0 mm to simulate a coronary artery. The tubes were filled with iodinated contrast medium diluted to 178 HU, closed at both ends and positioned in a plastic container filled with vegetable oil (-70-to -100 HU).A series of scans were performed with a 64-slice CT scanner with the following protocols: section thickness: 0.67 mm, 1.0 mm, 1.5 mm, 2.0 mm, pitch value: 0.2, 0.3, 0.5 and reconstruction interval of 50% overlap of the section thickness. 2D axial and multiplanar reformatted images were generated to assess the visibility of stent lumen, while virtual intravascular endoscopy (VIE) was reconstructed to evaluate the artery wall and stent surface. Results:Our results showed that a scanning protocol of 1.0 mm slice thickness with a pitch of 0.3 produced acceptable images with best demonstration of the intrastent lumen and stent surface with minimal image noise or artefacts. In contrast, submillimeter scans with 0.67 mm resulted in moderate artifacts which affected visualization of the coronary lumen, in addition to the increased noise. When the section thickness increased to 1.5 mm and 2.0 mm, visualization of the artery wall and stent surface was compromised, although the intrastent lumen was still visible. Conclusion:Our in vitro study suggested that a scanning protocol of 1. 0 mm section thickness with pitch of 0.3 is the optimal protocol for evaluation of coronary artery 3 stents as it allows generation of acceptable images with better visualization of stent lumen, stent surface and coronary artery wall.

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

Cited by 64 publications

References 34 publications

Clinical usefulness of the 16-slice computed tomography coronary angiography for evaluation of early phase intracoronary stent patency

Clinical usefulness of the 16-slice computed tomography coronary angiography for evaluation of early phase intracoronary stent patency

Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT

Optimal scanning protocols of 64-slice CT angiography in coronary artery stents: An in vitro phantom study

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