Abstract
Background
Numerous studies have compared coronary CT angiography (CTA) with quantitativecoronary
angiography. However, the ability of coronary CTA to identify atherosclerosis and
to accurately measure plaque and coronary area and volume measurements as compared
with intravascular ultrasound (IVUS) has not been fully defined.
Objective
We sought to assess the ability of coronary CTA to quantify coronary and plaque measurements
commonly performed with IVUS.
Methods
We searched multiple databases for diagnostic studies that directly compared coronary
CTA and IVUS for coronary plaque detection, vessel luminal area, percentage of area
stenosis, plaque area, and plaque volume. We used a bivariate mixed-effects binomial
regression model to pool test sensitivity and specificity for detection of any coronary
plaque.
Results
Forty-two studies that evaluated 1360 patients (75% men; mean age, 59 years) were
identified. No significant difference was found between coronary CTA and IVUS measurements
of vessel lumen cross-sectional area, plaque area, percentage of area stenosis, or
plaque volume within the overall cohort and no difference for the measurement of cross-sectional
area (n = 5 studies) and plaque volume (n = 8 studies) among a subgroup that used
automated or semiautomated measurement techniques. Sensitivity and specificity of
coronary CTA to detect any plaque compared with IVUS were 93% and 92%, respectively,
with an area under the receiver-operating curve of 0.97.
Conclusions
Compared with IVUS, coronary CTA appears to be highly accurate for estimation of luminal
area, percentage of area stenosis, plaque volume, and plaque area and for detection
of plaque. The use of automated vessel and stenosis measurements appears promising
in limited studies to date.
Keywords
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Article info
Publication history
Published online: August 26, 2013
Accepted:
August 16,
2013
Received in revised form:
May 23,
2013
Received:
March 8,
2013
Footnotes
Drs Fischer and Hulten contributed equally to this study.
Conflict of interest: Dr. Voros has received grant support from Merck Inc; is an advisor for Toshiba and Vital Images; has received a salary from HDL Inc and Global Genomics Group LLC; and is owner or holds equity and stock in G3 Founders LLC, Innovations in Integrated Imaging LLC, Integrated Cardiovascular Research Group, LLC. Innovations in Integrated Imaging has pending patent application on Lesion-Specific Coronary Artery calcium scoring. The other authors report no conflict of interest.
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Published by Elsevier Inc.
