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Nov. 27 - CT Angiography Highly Accurate, Multicenter Trials Show

Computed tomography (CT) angiography is as accurate as an invasive angiogram in detecting coronary artery disease, according to the findings of the first two prospective multicenter 64-slice scanner trials presented at the annual meeting of the Radiological Society of North America (RSNA).

For the Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography (CORE-64) Trial, researchers at nine international centers studied 291 patients who were scheduled to undergo invasive coronary angiography for suspected or unknown coronary artery disease. The study found that 64-slice multidetector CT angiography was highly accurate in detecting blockages of greater than 50%, with a sensitivity of 85% and a specificity of 90%. The noninvasive exam was equal in accuracy to invasive angiography in its ability to identify patients to be referred for angioplasty or bypass surgery.

The Assessment by Coronary Computed Tomographic Angiography of Individuals UndeRgoing InvAsive Coronary AngiographY (ACCURACY) Trial compared 64-row coronary computed tomographic angiography (CCTA) to quantitative coronary angiography (QCA). The results demonstrated that CCTA is highly accurate in detecting coronary blockages in chest pain patients referred for invasive coronary angiography and is also an effective noninvasive method to exclude obstructive coronary blockages.

Sixteen institutions performed CCTA on 232 patients with typical or atypical chest pain prior to invasive coronary angiography. Findings were then compared to those of QCA, the reference standard used to quantify the results of the invasive coronary angiography.

A total of 82 blockages greater than 50% in 49 patients and 31 blockages greater than 70% were detected in 28 patients by QCA. Per-patient sensitivity and specificity of CCTA were 93% and 82%, respectively, for blockages greater than 50%, and 91% and 84% for blockages greater than 70%. In addition, negative predictive value was 97 to 99%.

Source: RSNA

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