Author + information
- Kushal Dighe,
- Payam Dehghani,
- Danny Marcuzzi,
- Vikram Prabhudesai,
- Tej Sheth,
- Ian Billingsley,
- Warren Ball,
- Waseem Sharieff and
- Asim Cheema
CT angiography (CTA) is a promising approach for detection of in stent restenosis (ISR) for stents >3 mm in diameter. Limited data is available for accuracy and reproducibility of current methods of visual assessment (VA) and quantitative CT analysis (QCT). In this study, we compare VA and QCT to assess diagnostic accuracy for ISR detection compared to quantitative coronary angiography (QCA).
Patients undergoing coronary angiography after LM stenting underwent 64 slice CTA within 30 days. Patients with eGFR<60 and significant arrhythmias were excluded. ISR was assessed by QCA and defined as ≥50% in stent luminal narrowing. VA was performed by 3 physicians (OB 1-3) and QCT (Aquarius iNtuition software) in a blinded manner on per stent basis. Overlapping stents were evaluated as a single stent.
41 patients and 53 LM stents were analyzed. Mean stent diameter = 3.5±0.67 mm. Intra observer agreement for VA was moderate to excellent (k = 0.65 to 1.0) while inter observer agreement between 3 physicians was slight to moderate (k = 0.17 to 0.65). There was no significant difference between results when analysis was limited to simple vs bifurcation stenting or acceptable vs excellent CT image quality.
Current techniques of VA and QCT for CTA analysis for detection of ISR have important shortcomings that limit its use for a wider application. Further enhancements in image acquisition, processing and analysis are highly desirable to optimize performance of CTA for the detection of ISR.
|VA – OB 1||33||98||87|
|VA – OB 2||11||98||83|
|VA – OB 3||22||88||77|
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: CT/Multimodality Ill
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1181-342
- 2013 American College of Cardiology Foundation