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Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography

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Abstract

To determine the value of dual-energy CT (DECT) and combined information of perfusion and angiography in diagnosing coronary artery disease (CAD), with single photon emission computed tomography (SPECT) and quantitative coronary angiography (QCA) as a reference standard. Thirty-four patients were enrolled in this study. DECT was used as a contrast-enhanced retrospectively ECG-gated scan protocol during the rest state and tubes were set at 140/100 kV. DECT angiography (DE-CTA) and DECT perfusion (DE-CTP) were calculated from two kV images. DE-CTP results were compared with SPECT and DE-CTA with QCA, respectively. The combined DE-CTP with DE-CTA data were compared to QCA in diagnosis of obstructive CAD (stenosis ≥ 50%). DECT showed diagnostic image quality in 31 patients. Using SPECT as a reference, DE-CTP had sensitivity of 68%, specificity of 93%, and sensitivity of 81%, and specificity of 92% for identifying any type of perfusion deficits on the segment- and territory-based analysis, respectively. Using QCA as a reference standard, DE-CTA showed sensitivity of 82%, specificity of 91% and accuracy of 86% for detecting ≥50% coronary stenosis on the vessel-based analysis, whereas the combination of DE-CTA and DE-CTP gave sensitivity of 90%, specificity of 86% and accuracy of 88% for detecting ≥50% coronary stenosis, respectively. Combination of DE-CTP and DE-CTA may improve diagnostic performance compared to CTA alone for the diagnosis of significant coronary stenosis.

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Authors and Affiliations

  1. Department of Radiology, Anzhen Hospital, Capital Medical University, 100029, Beijing, China

    Rui Wang, Wei Yu, Yongmei Wang, Yi He, Lin Yang, Tao Bi & Zhaoqi Zhang

  2. Department of Nuclear Medicine, Anzhen Hospital, Capital Medical University, 100029, Beijing, China

    Jian Jiao & Qian Wang

  3. Department of Cardiology, Anzhen Hospital, Capital Medical University, 100029, Beijing, China

    Liquan Chi & Yang Yu

Authors
  1. Rui Wang
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  2. Wei Yu
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  3. Yongmei Wang
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  4. Yi He
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  5. Lin Yang
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  6. Tao Bi
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  10. Yang Yu
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  11. Zhaoqi Zhang
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Correspondence to Zhaoqi Zhang.

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Wang, R., Yu, W., Wang, Y. et al. Incremental value of dual-energy CT to coronary CT angiography for the detection of significant coronary stenosis: comparison with quantitative coronary angiography and single photon emission computed tomography. Int J Cardiovasc Imaging 27, 647–656 (2011). https://doi.org/10.1007/s10554-011-9881-7

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  • DOI: https://doi.org/10.1007/s10554-011-9881-7

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