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.
PY - 2016/8/25
Y1 - 2016/8/25
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.
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U2 - 10.1097/RCT.0000000000000481
DO - 10.1097/RCT.0000000000000481
M3 - Article
C2 - 27560020
AN - SCOPUS:84983471979
JO - Journal of Computer Assisted Tomography
JF - Journal of Computer Assisted Tomography
SN - 0363-8715
ER -