Abstract 1908: Noninvasive Coronary Angiography Using 256-slice Multislice Computed Tomography
Introduction Multislice computed tomography (MSCT), especially 64-slice CT, has been widely used for the noninvasive detection of coronary artery stenosis. Recent technological advancements have allowed the development of a 256-slice MSCT system. We compared the diagnostic accuracy of 256-slice MSCT coronary angiography versus conventional, invasive coronary angiography.
Method: Consecutive 10 patients who underwent invasive coronary angiography (CAG) within 2 weeks were enrolled in this study and scanned on 256-slice CT. The 256-slice MSCT (prototype, Toshiba Medical Systems, Japan) scanner acquires 256x0.5 mm slices with a 500ms rotation time. Images of each patient were acquired in 3 seconds and reconstructed by segmented reconstruction. This study was approved by the institutional review board and the internal ethics committee and all patients consented to participate in the study protocol.
Results: One hundred one coronary segments (>2mm of diameter) were examined by invasive CAG and MSCT, and no segments were excluded due to motion artifact. Compared with invasive CAG for detection of significant lesions (>50%), segment based sensitivity, specificity, and positive and negative predictive values of MSCT were 100%, 96%, 73% and 100%, respectively, when severe calcification was excluded. When severe calcification was assumed as stenosis, sensitivity, specificity, and positive and negative predictive values of MSCT were 100%, 90%, 61% and 100%, respectively.
Conclusion: 256-slice MSCT (prototype) shows great promise as a useful tool for the assessment of coronary artery stenosis. Equipment of ECG-gated scan, faster rotation times and methods of radiation dose reduction will make machines more useful and convenient by commercial availability.