title: Diagnostic accuracy of image postprocessing methods for the detection of coronary artery stenoses by using multidetector CT.
abstract: OBJECTIVE
  To retrospectively evaluate the diagnostic accuracy of multidetector computed tomography (CT) coronary angiography for detection of hemodynamically significant (>or=50%) stenoses by using various image postprocessing methods, with conventional coronary angiography as the reference standard.
  
  
  METHODS
  The analysis used data from previous studies, use of which had been approved by the Institutional Review Board. Sixteen-section multidetector CT data sets for 40 patients (30 men, 10 women; mean age 56 years +/- 8; mean heart rate, 61 beats per minute +/- 6) were evaluated. Six independent investigators evaluated the data sets for the presence of stenoses with diameter reduction of 50% or more, by using either exclusively transverse images, free oblique multiplanar reconstructions (MPRs), free oblique maximum intensity projections (MIPs, 5 mm thick), prerendered curved MPRs, prerendered curved MIPs, or prerendered three-dimensional volume rendered reconstructions (VRTs). Evaluation results were compared with conventional coronary angiography for each artery in a blinded fashion (chi(2) test).
  
  
  RESULTS
  Overall, 35 coronary artery stenoses were present. Percentage of evaluable arteries and accuracy for detecting stenosis (percentages of accurately classified arteries were, respectively, 99% and 88% for transverse, 99% and 91% for oblique MPR, 94% and 86% for oblique MIP, 94% and 83% for curved MIP, 93% and 81% for curved MPR, and 91% and 73% for VRT). Accuracy was significantly higher for oblique MPR than for curved MPR (P=.01), curved MIP (P=.03), and VRT (P<.001).
  
  
  CONCLUSIONS
  The evaluation of multidetector CT coronary angiography with interactive image display methods, especially interactive oblique MPRs, permits higher diagnostic accuracy than evaluation of prerendered images (curved MPR, curved MIP, or VRT images).
authors.affiliation: Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Maros
authors.initials: M
authors.lastname: Ferencik
authors.forename: Dieter
authors.initials: D
authors.lastname: Ropers
authors.forename: Suhny
authors.initials: S
authors.lastname: Abbara
authors.forename: Ricardo C
authors.initials: RC
authors.lastname: Cury
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Koen
authors.initials: K
authors.lastname: Nieman
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Brady
authors.forename: Fabian
authors.initials: F
authors.lastname: Moselewski
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
mesh_terms: D000465:Algorithms; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*