Imaging coronary and extracoronary atherosclerosis: feasibility and impact of whole-body computed tomography angiography.
A comprehensive whole-body approach to noninvasive evaluation of coronary and extracoronary vasculature is currently not available. The objective of our study was to assess the potential of 64-slice computed tomography angiography (64-CTA) for whole-body evaluation of atherosclerosis burden. Seventy-eight patients referred for coronary imaging underwent whole-body 64-CTA using an adjusted strategy for the administration of contrast medium with dose-saving algorithms involving ECG modulation and reduced tube voltage. Arterial segments (15 coronary, 32 systemic) were evaluated for significant (> or =50%) steno-occlusive disease while arterovenous density was evaluated at seven extracoronary locations. Homogeneous attenuation (mean 321 +/- 20 HU) was obtained throughout the systemic vasculature. Atherosclerosis was observed in 238/995 (24%) coronary and 368/2441 (15%) systemic segments. Significant stenoses/occlusions were present in 214 (21%)/24 (2.5%) coronary segments while asymptomatic clinically relevant stenoses were present in 49 systemic segments. Sensitivity, specificity, positive and negative predictive values of coronary 64-CTA among 52 patients who also underwent quantitative coronary angiography were 92%, 95%, 81% and 98%, respectively. ECG modulation decreased radiation exposure to 14.1-15.4 mSv per patient. Comprehensive, noninvasive assessment of atherosclerosis can be performed by whole-body 64-CTA and may have a positive impact on secondary prevention.
Napoli
Alessandro
A
Cardiovascular Imaging Unit, Department of Radiological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00184, Rome, Italy. alessandro.napoli@uniroma1.it
Catalano
Carlo
C
Francone
Marco
M
Sciacca
Vincenzo
V
Carbone
Iacopo
I
Greco
Cesare
C
Anzidei
Michele
M
Calabrese
Francesca Antonella
FA
Marincola
Beatrice Cavallo
BC
Kirchin
Miles A
MA
Vestri
Annarita
A
Arca
Marcello
M
Iuliano
Luigi
L
Passariello
Roberto
R
D000792:Angiography / Q000379:methods*; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; 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 / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*