title: Diagnostic accuracy of low-dose 256-slice multi-detector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease.
abstract: OBJECTIVE
  To evaluate the accuracy of low-dose coronary CTA with iterative reconstruction (IR) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD.
  
  
  METHODS
  Ninety-six patients with suspected CAD underwent low-dose prospective electrocardiogram-gated coronary CTA, with images reconstructed using IR. Image quality (IQ) of coronary segments were graded on a 4-point scale (4, excellent; 1, non-diagnostic). With invasive coronary angiography (ICA) considered the "gold standard", the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of coronary CTA were calculated on segment-, vessel- and patient-based levels. The patient data were divided into two groups (Agatston scores of ≥ 400 and <400). The differences in diagnostic performance between the two groups were tested.
  
  
  RESULTS
  Diagnostic image quality was found in 98.1 % (1,232/1,256) of segments. The sensitivity, specificity, PPV, NPV and accuracy were 90.8 %, 95.3 %, 81.8 %, 97.8 % and 94.3 % (segment-based) and 97.2 %, 83.3 %, 94.6 %, 90.9 % and 93.8 % (patient-based). Significant differences between the two groups were seen in specificity, PPV and accuracy (92.1 % vs. 97.9 %, 76.0 % vs. 86.7 %, 91.7 % vs. 96.6 %, P < 0.05; segment-based). The average effective dose was 1.30 ± 0.15 mSv.
  
  
  CONCLUSIONS
  Low-dose prospective coronary CTA with IR can acquire satisfactory image quality and show high diagnostic accuracy in patients with suspected CAD; however, blooming continues to pose a challenge in severely calcified segments.
  
  
  CONCLUSIONS
  • Coronary artery disease (CAD) is increasingly investigated using coronary CTA. • The iterative reconstruction (IR) algorithm is promising in decreasing radiation doses. • Low-dose prospective coronary CTA with IR can acquire satisfactory image quality. • Low-dose prospective coronary CTA with IR can show high diagnostic accuracy.
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China, houyang1973@163.com.
authors.forename: Yang
authors.initials: Y
authors.lastname: Hou
authors.forename: Yue
authors.initials: Y
authors.lastname: Ma
authors.forename: Weipeng
authors.initials: W
authors.lastname: Fan
authors.forename: Yuke
authors.initials: Y
authors.lastname: Wang
authors.forename: Mei
authors.initials: M
authors.lastname: Yu
authors.forename: Mani
authors.initials: M
authors.lastname: Vembar
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D011829:Radiation Dosage; D015203:Reproducibility of Results