title: Can Discrepancies Between Coronary Computed Tomography Angiography and Cardiac Catheterization in High-Risk Patients be Overcome With Consensus Reading?
abstract: OBJECTIVE
  To assess the incidence and cause of discrepancies between coronary computed tomography angiography (CTA) and catheterization in a high-risk, diverse, predominantly overweight inner-city population.
  
  
  METHODS
  Ninety-two patients who underwent coronary CTA and catheterization on March 2007 to December 2012 were retrospectively identified. Clinical coronary CTA interpretation and reinterpretation by a review panel was compared with catheterization results.
  
  
  RESULTS
  Severe stenosis was present on catheterization in 65% (60/92). Clinical coronary CTA was concordant with catheterization for severe stenosis in 78% (72/92), whereas panel interpretation was concordant in 77% (70/91). Sensitivity and specificity of clinical and panel coronary CTA interpretations were 92% (55/60) and 53% (17/32) versus 82% (48/59) and 68% (22/32), respectively.
  
  
  CONCLUSIONS
  Both coronary CTA interpretations were concordant with catheterization for severe stenosis in three quarters of patients. However, the diagnostic profile of the 2 interpretations differed, with higher sensitivity for the clinical report. This supports the clinical practice, which favored overestimation of difficult to quantify stenoses.
authors: From the Departments of *Radiology, †Medicine, and ‡Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
authors: Sharon
authors: S
authors: Steinberger
authors: Andrew J
authors: AJ
authors: Plodkowski
authors: Larry
authors: L
authors: Latson
authors: Jeffrey M
authors: JM
authors: Levsky
authors: Benjamin
authors: B
authors: Zalta
authors: Alla
authors: A
authors: Godelman
authors: Hillel W
authors: HW
authors: Cohen
authors: Linda B
authors: LB
authors: Haramati
mesh_terms: D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D000072226:Computed Tomography Angiography / Q000706:statistics & numerical data*; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015588:Observer Variation; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity