title: Diagnostic accuracy of high-pitch dual-source CT for the assessment of coronary stenoses: first experience.
abstract: OBJECTIVE
  The objective was to prospectively investigate the diagnostic accuracy of high-pitch (HP) dual-source computed tomography coronary angiography (CTCA) compared with catheter coronary angiography (CCA) for the diagnosis of significant coronary stenoses.
  
  
  METHODS
  Thirty-five patients (seven women; mean age 62 ± 8 years) underwent both CTCA and CCA. CTCA was performed with a second-generation dual-source CT system permitting data acquisition at an HP of 3.4. Patients with heart rates >60 bpm were excluded from study enrolment. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a four-point scale (1: excellent to 4: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). CCA served as the standard of reference. Radiation dose values were calculated using the dose-length product.
  
  
  RESULTS
  Diagnostic image quality was found in 99% of all segments (455/459). Non-diagnostic image quality occurred in a single patient with a sudden increase in heart rate immediately before and during CTCA. Taking segments with non-evaluative image quality as positive for disease, the sensitivity, specificity and positive and negative predictive values were 94, 96, 80 and 99% per segment and 100, 91, 88 and 100% per patient. The effective radiation dose was on average 0.9 ± 0.1 mSv.
  
  
  CONCLUSIONS
  In patients with heart rates ≤60 bpm, CTCA using the HP mode of the dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenoses at sub-milli-Sievert doses.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.forename: Stephan
authors.initials: S
authors.lastname: Baumueller
authors.forename: Robert
authors.initials: R
authors.lastname: Goetti
authors.forename: Thomas
authors.initials: T
authors.lastname: Schertler
authors.forename: Hans
authors.initials: H
authors.lastname: Scheffel
authors.forename: Andre
authors.initials: A
authors.lastname: Plass
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*