Correlation between multi-detector CT findings and angiography reported stenosis in symptomatic coronary artery disease patients: Pilot study

The objective of this study was to correlate stenosis assessment results using multi-detector Computed Tomography (MDCT) in both Coronary Computed Tomography Angiography (CCTA) and Computed Tomography Calcium Score (CTCS) examinations with results of Invasive Coronary Angiography (ICA). A total of 24 symptomatic Coronary Artery Disease (CAD) patients who underwent CCTA and/or CTCS following ICA were retrospectively analyzed. Mean age of the cohort was 62.3± 9.5 years. The diagnostic accuracy of CCTA was compared with ICA over three levels; segment-based, vessel-based and patient-based. CCTA correctly identified 30% of the segments with significant (=50%) stenosis. For the vessel-based evaluation, 80% of Left Main (LM) arteries were correctly identified as well as 93% of Left Anterior Descending (LAD), 87%o of Left Circumflex (LCX) and 87% of Right Coronary Artery (RCA). For the patient-based analysis, the area under receiver-operating characteristic (ROC) curve was 0.990 for 50% stenosis threshold and 0.974 for 70%o stenosis threshold. CTCS area under ROC curve was lower than that of CCTA (0.976). 19% of the vessels reported with 0 calcium score by CTCS were shown to contain a certain level of stenosis when compared with ICA. Herein, MDCT was found to be a reliable method in detecting and accurately ruling out significant stenosis by CCTA examinations. However due to the inaccuracy of CTCS in reporting vessels with 0 calcium score as stenosis-free, CTCS would be better in detecting significant stenosis than excluding stenosis.