title: Reproducibility of coronary plaque detection and characterization using low radiation dose coronary computed tomographic angiography in patients with intermediate likelihood of coronary artery disease (ReSCAN study).
abstract: The purpose of this study is to evaluate the interscan, interobserver and intraobserver agreement for coronary plaque detection, and characterization using low radiation dose high-pitch spiral acquisition coronary CT angiography (CTA). Two experienced observers independently evaluated coronary CTA datasets from 50 consecutive patients undergoing two 128-slice dual source CT scans within 12 days. Mean (±SD) estimated radiation exposure was 1.5 ± 0.2 mSv per scan. Observers recorded the presence and characterization of coronary plaques as non-calcified or calcified. A "segment involvement score" (SIS) was computed by summing the numbers of segments with any coronary plaque per patient. Reproducibility was assessed using kappa (κ) statistics, paired t test and Bland-Altman analyses. Interscan, interobserver, and intraobserver agreement (κ-values) for detection of any or calcified plaques were 83-94% (κ-values 0.57-0.85), and 67-84% (0.31-0.67) for non-calcified plaques on a patient level. No significant difference was observed in mean interscan or interobserver SIS. Mean (95% CI) intraobserver SIS difference was -0.88 (-1.25; -0.51), P < 0.001, with limits of agreement from -4.7 to 2.9. Low radiation dose high-pitch coronary CTA permits detection of any or calcified plaques with high interscan, interobserver, intraobserver agreement. However, variability for the detection of non-calcified plaque is substantial.
authors.affiliation: Department of Cardiology, Lillebealt Hospital-Vejle, Kabbeltoft 25, 7100, Vejle, Denmark. kristianovrehus@hotmail.com
authors.forename: Kristian Altern
authors.initials: KA
authors.lastname: Øvrehus
authors.forename: Mohamed
authors.initials: M
authors.lastname: Marwan
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Bjarne Linde
authors.initials: BL
authors.lastname: Nørgaard
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology*; D003718:Denmark; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D036542:Tomography, Spiral Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000473:pathology