Journal of Cardiovascular Computed Tomography
Volume 4, Issue 3 , Pages 186-194 , May 2010

Coronary computed tomographic angiography in patients suspected of coronary artery disease: Impact of observer experience on diagnostic performance and interobserver reproducibility

  • Kristian A. Øvrehus, MD

      Affiliations

    • Department of Cardiology, Lillebaelt Hospital, Kabbeltoft 25, DK-7100 Vejle, Denmark
    • Corresponding Author InformationCorresponding author.
  • ,
  • Henrik Munkholm, MD

      Affiliations

    • Department of Cardiology, Lillebaelt Hospital, Kabbeltoft 25, DK-7100 Vejle, Denmark
  • ,
  • Morten Bøttcher, MD, PhD

      Affiliations

    • Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
  • ,
  • Hans E. Bøtker, MD, PhD, DmSci

      Affiliations

    • Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
  • ,
  • Bjarne L. Nørgaard, MD, PhD

      Affiliations

    • Department of Cardiology, Lillebaelt Hospital, Kabbeltoft 25, DK-7100 Vejle, Denmark

Received 8 September 2009 ,Accepted 19 March 2010.

References 

  1. Schuijf JD, Pundziute G, Jukema JW, Lamb HJ, van der Hoeven BL, de RA, et al. Diagnostic accuracy of 64-slice multislice computed tomography in the noninvasive evaluation of significant coronary artery disease. Am J Cardiol. 2006;98:145–148
  2. Leber AW, Johnson T, Becker A, von ZF, Tittus J, Nikolaou K, et al. Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur Heart J. 2007;28:2354–2360
  3. Meijboom WB, van Mieghem CA, Mollet NR, Pugliese F, Weustink AC, van Pelt N, et al. 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol. 2007;50:1469–1475
  4. Hausleiter J, Meyer T, Hadamitzky M, Zankl M, Gerein P, Dorrler K, et al. Noninvasive coronary computed tomographic angiography for patients with suspected coronary artery disease: the Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. Eur Heart J. 2007;28:3034–3041
  5. Pugliese F, Mollet NR, Hunink MG, Cademartiri F, Nieman K, van Domburg RT, et al. Diagnostic performance of coronary CT angiography by using different generations of multisection scanners: single-center experience. Radiology. 2008;246:384–393
  6. Alkadhi H, Scheffel H, Desbiolles L, Gaemperli O, Stolzmann P, Plass A, et al. Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J. 2008;29:766–776
  7. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979;300:1350–1358
  8. Diamond GA. A clinically relevant classification of chest discomfort. J Am Coll Cardiol. 1983;1:574–575
  9. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–832
  10. Bongartz G, Golding SJ, Jurik AG, Leonardi M, van Persijn van Meerten E, Rodriguez R, Schneider K, Calzado A, Geleijns J, Jessen KA, Panzer W, Shrimpton PC, Tosi G: European Guidelines for Multislice Computed Tomography: 2004 CT Quality Criteria, Appendix C. Available at: http://www.msct.eu/PDF_FILES/EC%20CA%20Report%20D5%20-%20Dosimetry.pdf. Accessed August 18, 2009.
  11. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975;51:5–40
  12. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174
  13. Bossuyt PM, Reitsma JB. The STARD initiative. Lancet. 2003;361:71
  14. Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85:257–268
  15. Miller JM, Rochitte CE, Dewey M, rbab-Zadeh A, Niinuma H, Gottlieb I, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008;359:2324–2336
  16. Meijboom WB, Meijs MF, Schuijf JD, Cramer MJ, Mollet NR, van Mieghem CA, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008;52:2135–2144
  17. Baylor Al. A U-shaped model for the development of intuition by level of expertise. New Ideas Psychol. 2001;19:237–244
  18. Pugliese F, Hunink MG, Gruszczynska K, Alberghina F, Malago R, van Pelt N, et al. Learning curve for coronary CT angiography: what constitutes sufficient training?. Radiology. 2009;251:359–368
  19. Budoff MJ, Achenbach S, Berman DS, Fayad ZA, Poon M, Taylor AJ, et al. Task force 13: training in advanced cardiovascular imaging (computed tomography) endorsed by the American Society of Nuclear Cardiology, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, and Society of Cardiovascular Computed Tomography. J Am Coll Cardiol. 2008;51:409–414
  20. Mori S, Nishizawa K, Kondo C, Ohno M, Akahane K, Endo M. Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner. Eur J Radiol. 2008;65:442–448
  21. Scheffel H, Alkadhi H, Leschka S, Plass A, Desbiolles L, Guber I, et al. Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart. 2008;94:1132–1137
  22. Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J. 2010;31:340–346

 Conflict of interest: The authors report no conflicts of interest.

 This work was supported by a grant from Vejle Hospital Research Foundation.

PII: S1934-5925(10)00140-1

doi: 10.1016/j.jcct.2010.03.010

Journal of Cardiovascular Computed Tomography
Volume 4, Issue 3 , Pages 186-194 , May 2010