title: Diagnostic confidence of run-off CT-angiography as the primary diagnostic imaging modality in patients presenting with acute or chronic peripheral arterial disease.
abstract: OBJECTIVE
  To investigate the reliability of CT-angiography of the lower extremities (run-off CTA) to derive a treatment decision in patients with acute and chronic peripheral artery disease (PAD).
  
  
  METHODS
  314 patients referred for run-off CTA were includ-ed in this retrospective study. First, diagnostic confidence of run-off CTA to derive a treat-ment decision was assessed in an interdisciplinary vascular conference using a 2 point scale (sufficient or not sufficient diagnostic confidence) and compared with the image quality eval-uated by two readers in consensus in four different levels (abdominopelvic, thigh, calf, foot arteries). Second, reliability of treatment decision was verified in all patients undergoing re-vascularization therapy.
  
  
  RESULTS
  Diagnostic confidence of run-off CTA to derive a treatment deci-sion was sufficient in all patients with acute and in 97% of patients (215/221) with chronic PAD, whereas the rate of run-off CTA with non-diagnostic image quality was considerably higher in the calf and foot level (acute vs. chronic; calf: 28% vs.17%; foot: 52% vs. 20%). Reliability of treatment decision was superior for patients with chronic (123/133 = 92%) than for patients with acute PAD (64/78 = 82%, P = 0.02).
  
  
  CONCLUSIONS
  Run-off CTA is a reliable imaging modality for primary diag-nostic work-up of patients with acute and chronic PAD.
authors.affiliation: Klinik für Radiologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Werncke
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Kristina Imeen
authors.initials: KI
authors.lastname: Ringe
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: von Falck
authors.affiliation: Klinik für Radiologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kruschewski
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Wacker
authors.affiliation: Klinik für Radiologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Bernhard Christian
authors.initials: BC
authors.lastname: Meyer
mesh_terms: D000208:Acute Disease; D000792:Angiography / Q000379:methods*; D002908:Chronic Disease; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000628:therapy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
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