Author + information
- Kushal Dighe,
- Waseem Sharieff,
- Payam Dehghani,
- Danny Marcuzzi,
- Vikram Prabhudesai,
- Tej Sheth,
- Ian Billingsley,
- Warren Ball and
- Asim Cheema
Current method of visual CT angiographic (CTA) analysis is hampered by high variability and poor reproducibility for detection of in-stent restenosis (ISR). In this report, we describe a new method of CTA analysis using contrast density gradient (CDG) and report its performance for ISR detection compared to gold standard quantitative coronary angiography (QCA).
Consenting patients undergoing invasive coronary angiography after LM stenting underwent 64 slice CTA (GE LightSpeed) within 30 days. Patients with renal insufficiency and significant arrhythmia were excluded. ISR was assessed by QCA and defined as ≥50% in-stent lumen narrowing. CDG was calculated as % difference between pre-stent contrast density and lowest of in-stent and post-stent density. ROC curves were used to choose cut off value that would maximize sensitivity and specificity. All measurements were completed in a blinded manner on per stent basis.
41 patients with 53 stents (27 simple, 26 complex bifurcation stent techniques) were analyzed. Mean stent diameter was 3.5±0.67 mm. >25% reduction in contrast gradient density (CDG 25) on CTA gave maximum sensitivity and specificity for detection of ISR when compared to ≥50% in-stent lumen narrowing on QCA
CTA analysis by CDG 25 method offers excellent sensitivity and specificity for detection of ISR after LM stenting regardless of stenting technique and offers a useful noninvasive tool in selected patients.
|True Positive||True Negative||False Positive||False Negative||Sensitivity||Specificity||Accuracy|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: CT/Multimodality II
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1141-345
- 2013 American College of Cardiology Foundation