title: Coronary artery disease: diagnostic accuracy of CT coronary angiography--a comparison of high and standard spatial resolution scanning.
abstract: OBJECTIVE
  To compare the image quality, evaluability, diagnostic accuracy, and radiation exposure of high-spatial-resolution (HR, 0.23-mm) computed tomographic (CT) coronary angiography with standard spatial resolution (SR, 0.625-mm) 64-section imaging in patients at high risk for coronary artery disease (CAD) by using invasive coronary angiography (ICA) as the reference method.
  
  
  METHODS
  Written informed consent was obtained from all patients, and the study protocol was approved by the institutional ethical committee. Patients at high risk for CAD (n = 184) who were scheduled for ICA were randomly assigned for study with SR (n = 91) or HR (n = 93) coronary CT angiography before they underwent ICA. To compare the two groups, the Student t test or Wilcoxon test were used to evaluate differences in continuous variables. The χ(2) test or Fisher exact test were used, as appropriate, for categorical data. The McNemar test was used to compare the diagnostic performance of coronary CT angiography versus that of ICA in each group.
  
  
  RESULTS
  HR coronary CT angiography showed a higher image quality score (3.7 vs 3.4, P < .001) and evaluability (97% vs 92%, P < .002). In a segment-based analysis, HR coronary CT angiography showed a higher specificity, positive predictive value, and accuracy in comparison with SR coronary CT angiography (98%, 91%, and 99% vs 95%, 80%, and 95%, respectively; P < .001). Moreover, HR coronary CT angiography showed a better agreement with ICA for calcified plaques compared with SR coronary CT angiography and ICA (83% vs 53%, P < .001). In a patient-based analysis, HR coronary CT angiography showed higher specificity and accuracy compared with SR coronary CT angiography (91% and 98% vs 46% and 92%, respectively; P < .01). No differences in radiation exposure were found between the two groups.
  
  
  CONCLUSIONS
  Improved evaluability and accuracy were seen with HR compared with SR coronary CT angiography of calcified coronary artery lesions, suggesting a potential use for this technology in patients at high risk for CAD.
authors: From the Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy (G.P., E.B., S.M., M.L., S.C., A.B., E.C., A.A., A.F., V.B., D.A.); Department of Cardiology, University of Foggia, Foggia, Italy (A.I.G.); and Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy (D.A.).
authors: Gianluca
authors: G
authors: Pontone
authors: Erika
authors: E
authors: Bertella
authors: Saima
authors: S
authors: Mushtaq
authors: Monica
authors: M
authors: Loguercio
authors: Sarah
authors: S
authors: Cortinovis
authors: Andrea
authors: A
authors: Baggiano
authors: Edoardo
authors: E
authors: Conte
authors: Andrea
authors: A
authors: Annoni
authors: Alberto
authors: A
authors: Formenti
authors: Virginia
authors: V
authors: Beltrama
authors: Andrea Igoren
authors: AI
authors: Guaricci
authors: Daniele
authors: D
authors: Andreini
mesh_terms: D000465:Algorithms; D016477:Artifacts; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol