TY - JOUR
T1 - Can discrepancies between coronary computed tomography angiography and cardiac catheterization in high-risk patients be overcome with consensus reading?
AU - Steinberger, Sharon
AU - Plodkowski, Andrew J.
AU - Latson, Larry
AU - Levsky, Jeffrey M.
AU - Zalta, Benjamin
AU - Godelman, Alla
AU - Cohen, Hillel W.
AU - Haramati, Linda B.
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Objective: To assess the incidence and cause of discrepancies between coronary computed tomography angiography (CTA) and catheterization in a high-risk, diverse, predominantly overweight inner-city population. Methods: Ninety-two patients who underwent coronary CTA and catheterization on March 2007 to December 2012 were retrospectively identified. Clinical coronary CTA interpretation and reinterpretation by a review panel was compared with catheterization results. Results: Severe stenosis was present on catheterization in 65% (60/92). Clinical coronary CTA was concordant with catheterization for severe stenosis in 78% (72/92), whereas panel interpretation was concordant in 77% (70/91). Sensitivity and specificity of clinical and panel coronary CTA interpretations were 92% (55/60) and 53% (17/32) versus 82% (48/59) and 68% (22/32), respectively. Conclusions: Both coronary CTA interpretations were concordant with catheterization for severe stenosis in three quarters of patients. However, the diagnostic profile of the 2 interpretations differed, with higher sensitivity for the clinical report. This supports the clinical practice, which favored overestimation of difficult to quantify stenoses.
AB - Objective: To assess the incidence and cause of discrepancies between coronary computed tomography angiography (CTA) and catheterization in a high-risk, diverse, predominantly overweight inner-city population. Methods: Ninety-two patients who underwent coronary CTA and catheterization on March 2007 to December 2012 were retrospectively identified. Clinical coronary CTA interpretation and reinterpretation by a review panel was compared with catheterization results. Results: Severe stenosis was present on catheterization in 65% (60/92). Clinical coronary CTA was concordant with catheterization for severe stenosis in 78% (72/92), whereas panel interpretation was concordant in 77% (70/91). Sensitivity and specificity of clinical and panel coronary CTA interpretations were 92% (55/60) and 53% (17/32) versus 82% (48/59) and 68% (22/32), respectively. Conclusions: Both coronary CTA interpretations were concordant with catheterization for severe stenosis in three quarters of patients. However, the diagnostic profile of the 2 interpretations differed, with higher sensitivity for the clinical report. This supports the clinical practice, which favored overestimation of difficult to quantify stenoses.
KW - Consensus reading
KW - Coronary CT angiography
KW - Coronary artery calcium
KW - Coronary artery disease
KW - Diagnostic performance
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U2 - 10.1097/RCT.0000000000000481
DO - 10.1097/RCT.0000000000000481
M3 - Article
C2 - 27560020
AN - SCOPUS:84983471979
SN - 0363-8715
VL - 41
SP - 159
EP - 164
JO - Journal of computer assisted tomography
JF - Journal of computer assisted tomography
IS - 1
ER -