Multi-detector row CT angiography in the assessment of coronary in-stent restenosis

A systematic review

Zhonghua Sun, Robert Davidson, Cheng HSun Lin

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: The aim of this study was to perform a systematic review of the diagnostic accuracy of multi-detector row computed tomography angiography (MDCT) for detection of coronary in-stent restenosis in patients treated with coronary stenting when compared to invasive catheter angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 16- or more detector rows MDCT angiography with invasive catheter angiography in the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: 15 studies met selection criteria for inclusion in the analysis. There were eight studies performed with 16-detector row CT scanners, and five studies with 64-detector row scanners and one study with a 40-detector scanner. The remaining study was performed with a mixture of 16-and 64-detector row scanners. Prevalence of in-stent restenosis following coronary stenting was 18% (95% CI: 13, 24%). Pooled estimates of the sensitivity and specificity of overall MDCT angiography for the detection of coronary in-stent restenosis was 85% (95% CI: 78, 90%) and 97% (95% CI: 95, 98%), respectively. No significant difference was found between 16- and 64-detector row scanners regarding the sensitivity and specificity of MDCT for assessment of in-stent restenosis (p > 0.05). Conclusion: The results showed that MDCT angiography (with 16 or more detector rows) has moderate sensitivity and high specificity for the detection of coronary in-stent restenosis when compared to invasive catheter angiography. A high specificity value of MDCT may be most valuable as a non-invasive technique of excluding coronary stent restenosis or occlusion. The main factors affecting visualization are stent diameters and stent materials.

Original languageEnglish
Pages (from-to)489-495
Number of pages7
JournalEuropean Journal of Radiology
Volume69
Issue number3
DOIs
Publication statusPublished - 1 Mar 2009
Externally publishedYes

Fingerprint

Stents
Angiography
Coronary Restenosis
Sensitivity and Specificity
Catheters
Literature
Computed Tomography Angiography
Coronary Occlusion
Coronary Angiography
MEDLINE
Patient Selection
Pathologic Constriction
Databases

Cite this

@article{f410e530b8fd454eb7d0f5f44d45cefe,
title = "Multi-detector row CT angiography in the assessment of coronary in-stent restenosis: A systematic review",
abstract = "Purpose: The aim of this study was to perform a systematic review of the diagnostic accuracy of multi-detector row computed tomography angiography (MDCT) for detection of coronary in-stent restenosis in patients treated with coronary stenting when compared to invasive catheter angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 16- or more detector rows MDCT angiography with invasive catheter angiography in the detection of coronary in-stent restenosis (more than 50{\%} stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: 15 studies met selection criteria for inclusion in the analysis. There were eight studies performed with 16-detector row CT scanners, and five studies with 64-detector row scanners and one study with a 40-detector scanner. The remaining study was performed with a mixture of 16-and 64-detector row scanners. Prevalence of in-stent restenosis following coronary stenting was 18{\%} (95{\%} CI: 13, 24{\%}). Pooled estimates of the sensitivity and specificity of overall MDCT angiography for the detection of coronary in-stent restenosis was 85{\%} (95{\%} CI: 78, 90{\%}) and 97{\%} (95{\%} CI: 95, 98{\%}), respectively. No significant difference was found between 16- and 64-detector row scanners regarding the sensitivity and specificity of MDCT for assessment of in-stent restenosis (p > 0.05). Conclusion: The results showed that MDCT angiography (with 16 or more detector rows) has moderate sensitivity and high specificity for the detection of coronary in-stent restenosis when compared to invasive catheter angiography. A high specificity value of MDCT may be most valuable as a non-invasive technique of excluding coronary stent restenosis or occlusion. The main factors affecting visualization are stent diameters and stent materials.",
keywords = "Artifacts, Coronary artery disease, Multi-detector computed tomography, Restenosis, Stent",
author = "Zhonghua Sun and Robert Davidson and Lin, {Cheng HSun}",
year = "2009",
month = "3",
day = "1",
doi = "10.1016/j.ejrad.2007.11.030",
language = "English",
volume = "69",
pages = "489--495",
journal = "Journal of Medical Imaging",
issn = "0720-048X",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

Multi-detector row CT angiography in the assessment of coronary in-stent restenosis : A systematic review. / Sun, Zhonghua; Davidson, Robert; Lin, Cheng HSun.

In: European Journal of Radiology, Vol. 69, No. 3, 01.03.2009, p. 489-495.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multi-detector row CT angiography in the assessment of coronary in-stent restenosis

T2 - A systematic review

AU - Sun, Zhonghua

AU - Davidson, Robert

AU - Lin, Cheng HSun

PY - 2009/3/1

Y1 - 2009/3/1

N2 - Purpose: The aim of this study was to perform a systematic review of the diagnostic accuracy of multi-detector row computed tomography angiography (MDCT) for detection of coronary in-stent restenosis in patients treated with coronary stenting when compared to invasive catheter angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 16- or more detector rows MDCT angiography with invasive catheter angiography in the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: 15 studies met selection criteria for inclusion in the analysis. There were eight studies performed with 16-detector row CT scanners, and five studies with 64-detector row scanners and one study with a 40-detector scanner. The remaining study was performed with a mixture of 16-and 64-detector row scanners. Prevalence of in-stent restenosis following coronary stenting was 18% (95% CI: 13, 24%). Pooled estimates of the sensitivity and specificity of overall MDCT angiography for the detection of coronary in-stent restenosis was 85% (95% CI: 78, 90%) and 97% (95% CI: 95, 98%), respectively. No significant difference was found between 16- and 64-detector row scanners regarding the sensitivity and specificity of MDCT for assessment of in-stent restenosis (p > 0.05). Conclusion: The results showed that MDCT angiography (with 16 or more detector rows) has moderate sensitivity and high specificity for the detection of coronary in-stent restenosis when compared to invasive catheter angiography. A high specificity value of MDCT may be most valuable as a non-invasive technique of excluding coronary stent restenosis or occlusion. The main factors affecting visualization are stent diameters and stent materials.

AB - Purpose: The aim of this study was to perform a systematic review of the diagnostic accuracy of multi-detector row computed tomography angiography (MDCT) for detection of coronary in-stent restenosis in patients treated with coronary stenting when compared to invasive catheter angiography. Materials and methods: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 16- or more detector rows MDCT angiography with invasive catheter angiography in the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results: 15 studies met selection criteria for inclusion in the analysis. There were eight studies performed with 16-detector row CT scanners, and five studies with 64-detector row scanners and one study with a 40-detector scanner. The remaining study was performed with a mixture of 16-and 64-detector row scanners. Prevalence of in-stent restenosis following coronary stenting was 18% (95% CI: 13, 24%). Pooled estimates of the sensitivity and specificity of overall MDCT angiography for the detection of coronary in-stent restenosis was 85% (95% CI: 78, 90%) and 97% (95% CI: 95, 98%), respectively. No significant difference was found between 16- and 64-detector row scanners regarding the sensitivity and specificity of MDCT for assessment of in-stent restenosis (p > 0.05). Conclusion: The results showed that MDCT angiography (with 16 or more detector rows) has moderate sensitivity and high specificity for the detection of coronary in-stent restenosis when compared to invasive catheter angiography. A high specificity value of MDCT may be most valuable as a non-invasive technique of excluding coronary stent restenosis or occlusion. The main factors affecting visualization are stent diameters and stent materials.

KW - Artifacts

KW - Coronary artery disease

KW - Multi-detector computed tomography

KW - Restenosis

KW - Stent

UR - http://www.scopus.com/inward/record.url?scp=63149180645&partnerID=8YFLogxK

U2 - 10.1016/j.ejrad.2007.11.030

DO - 10.1016/j.ejrad.2007.11.030

M3 - Article

VL - 69

SP - 489

EP - 495

JO - Journal of Medical Imaging

JF - Journal of Medical Imaging

SN - 0720-048X

IS - 3

ER -