title: Coronary artery disease in patients with cardiac tumors: preoperative assessment by computed tomography coronary angiography.
abstract: We studied the diagnostic accuracy of computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary artery disease (CAD) compared to conventional coronary angiography (CCA) in patients with primary cardiac tumors. Thirty-eight consecutive patients with primary cardiac tumors (27 females, 11 males; mean age 56+/-6 years, range 32-86 years) underwent dual-source CTCA and CCA. Significant stenosis was defined as diameter reduction >50%. CCA served as the standard of reference. The prevalence of significant CAD in the study population was 8% (3/38 patients). Five of 544 segments (0.9%) in 1/38 patients (2.6%) was considered of non-diagnostic image quality on CTCA because of motion artifacts. In a segment-based analysis taking not-evaluative segments as false-positive, sensitivity, specificity, positive and negative predictive value of CT was 100%, 99%, 70%, and 100%, respectively. Preoperative CCA could have been avoided in 95% (36/38) of the patients and CCA would have confirmed the CTCA diagnosis in 5% (2/38) of the patients. Our results indicate that CTCA provides a high diagnostic performance for diagnosing significant CAD in patients with primary cardiac tumors. CTCA may thus be used as a filter test prior to surgery.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital Zurich, Raemistr 100, 8091 Zurich, Switzerland. hans.scheffel@usz.ch
authors.forename: Hans
authors.initials: H
authors.lastname: Scheffel
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: André
authors.initials: A
authors.lastname: Plass
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Borut
authors.initials: B
authors.lastname: Marincek
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed