title: Accuracy of high-pitch prospectively ECG-triggering CT coronary angiography for assessment of stenosis in 103 patients: comparison with invasive coronary angiography.
abstract: OBJECTIVE
  To investigate the accuracy of high-pitch prospectively electrocardiogram (ECG)-triggering low-dose, dual-source computed tomography (CT) coronary angiography for assessing coronary artery stenosis compared with conventional coronary angiography.
  
  
  METHODS
  One hundred and three patients undergoing high-pitch CT coronary angiography (CTCA) and conventional coronary angiography (CCA) within 30 days were enrolled. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of high-pitch CTCA for detecting >50 and >70% stenosis were evaluated using CCA as the reference standard on a per-segment, per-vessel, and per-patient basis. Two experienced radiologists independently rated high-pitch CTCA images for quality using a four-point scale (1 = excellent, 4 = non-diagnostic) on a per-segment basis. The effective dose was calculated by multiplying the conversion coefficient of 0.028 by the dose-length product.
  
  
  RESULTS
  The mean heart rate of patients was 57 ± 6 beats/min. For detecting >50% stenosis, the sensitivity, specificity, PPV, and NPV of high-pitch CTCA were 89, 97, 87, and 97% on a per-segment basis; 91, 92, 92, and 91% on a per-vessel basis; and 99, 85, 96, and 94% on a per-patient basis. For detecting >70% stenosis, the sensitivity, specificity, PPV, and NPV of high-pitch CTCA were 96, 98, 90, and 99% on a per-segment basis. Coronary segments were rated as diagnostic in 98.6% (1355/1375) of cases (score 1, 72.5%; score 2, 23.1%; score 3, 3%; score 4, 1.4%). The effective dose of high-pitch CTCA was 1.51 ± 0.31 mSv.
  
  
  CONCLUSIONS
  High-pitch prospectively ECG-triggering dual-source CTCA provides good image quality and high diagnostic accuracy with a 1.51 mSv radiation dose.
authors.affiliation: Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.
authors.forename: X H
authors.initials: XH
authors.lastname: Hu
authors.forename: W L
authors.initials: WL
authors.lastname: Zheng
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.forename: S S
authors.initials: SS
authors.lastname: Xie
authors.forename: R
authors.initials: R
authors.lastname: Wu
authors.forename: S Z
authors.initials: SZ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods