RETRACTED: Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis

Abstract

Background Dual-source and 320-row computed tomography angiography (CTA) are increasingly used in diagnosing coronary in-stent restenosis (CISR). Purpose We sought to perform this meta-analysis to evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) and 320-row CTA in detecting CISR when compared to invasive coronary angiography. Material and Methods Five scientific databases (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were searched for research studies in which DSCTA and/or 320-row CTA were used as diagnostic tools for CISR, as recently as October 2017. Study inclusion, data extraction, systematic review, pooled meta-analysis, and subgroup analysis were conducted by two researchers independently. Results Thirteen studies with 1384 assessable stents on DSCTA and five studies including 622 assessable stents on 320-row CTA were finally included. The sensitivity, specificity, and area under the curve (AUC) of DSCTA in diagnosing CISR were 0.92 (0.87-0.96), 0.91 (0.87-0.94), and 0.97 (0.95-0.98), respectively, and they were 0.91 (0.82-0.96), 0.95 (0.88-0.98), and 0.96 (0.94-0.97) for 320-row CTA. Subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥ 3 mm compared to stent diameter < 3 mm: 0.98 (0.97-0.99) vs. 0.82 (0.79-0.86) with P < 0.05. Conclusion Our meta-analysis indicated both DSCTA and 320-row CTA had high diagnostic accuracy in detecting CISR and may serve as alternatives for further patient evaluation with CISR, especially for stent diameters ≥ 3 mm.

Personalized 3D printed coronary models in coronary stenting

“…Due to technological improvements in CT scanning techniques, CCTA has demonstrated high diagnostic accuracy in determining coronary stenosis and serves as a reliable gatekeeper for excluding obstructive coronary stenosis, even in patients with high heart rates (1)(2)(3)(4)(5)(6)(7). Coronary stenting is a commonly performed less invasive procedure following percutaneous coronary intervention for the treatment of patients with significant coronary artery stenosis, while stent patency and presence of in-stent restenosis is increasingly evaluated with CCTA, according to several systematic reviews and meta-analyses (8)(9)(10)(11)(12)(13). Despite reported high sensitivity and specificity of CCTA, the clinical application of CCTA for evaluation of coronary in-stent restenosis remains questionable because of beam-hardening artifacts which result in high false positive rates, leading to low positive predictive value, especially when assessing stents with diameter less than 3.0 mm (14,15).…”