title: Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography.
abstract: To determine the value of dual-energy CT (DECT) and combined information of perfusion and angiography in diagnosing coronary artery disease (CAD), with single photon emission computed tomography (SPECT) and quantitative coronary angiography (QCA) as a reference standard. Thirty-four patients were enrolled in this study. DECT was used as a contrast-enhanced retrospectively ECG-gated scan protocol during the rest state and tubes were set at 140/100 kV. DECT angiography (DE-CTA) and DECT perfusion (DE-CTP) were calculated from two kV images. DE-CTP results were compared with SPECT and DE-CTA with QCA, respectively. The combined DE-CTP with DE-CTA data were compared to QCA in diagnosis of obstructive CAD (stenosis ≥ 50%). DECT showed diagnostic image quality in 31 patients. Using SPECT as a reference, DE-CTP had sensitivity of 68%, specificity of 93%, and sensitivity of 81%, and specificity of 92% for identifying any type of perfusion deficits on the segment- and territory-based analysis, respectively. Using QCA as a reference standard, DE-CTA showed sensitivity of 82%, specificity of 91% and accuracy of 86% for detecting ≥50% coronary stenosis on the vessel-based analysis, whereas the combination of DE-CTA and DE-CTP gave sensitivity of 90%, specificity of 86% and accuracy of 88% for detecting ≥50% coronary stenosis, respectively. Combination of DE-CTP and DE-CTA may improve diagnostic performance compared to CTA alone for the diagnosis of significant coronary stenosis.
authors.affiliation: Department of Radiology, Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: He
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Tao
authors.initials: T
authors.lastname: Bi
authors.forename: Jian
authors.initials: J
authors.lastname: Jiao
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.forename: Liquan
authors.initials: L
authors.lastname: Chi
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Zhaoqi
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed