Can Discrepancies Between Coronary Computed Tomography Angiography and Cardiac Catheterization in High-Risk Patients be Overcome With Consensus Reading?

Sharon Steinberger, Andrew J. Plodkowski, Larry Latson, Jeffrey M. Levsky, Benjamin Zalta, Alla Godelman, Hillel W. Cohen, Linda B. Haramati

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Abstract

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.

Original languageEnglish (US)
JournalJournal of Computer Assisted Tomography
DOIs
StateAccepted/In press - Aug 25 2016

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Cardiac Catheterization
Catheterization
Reading
Pathologic Constriction
Computed Tomography Angiography
Sensitivity and Specificity
Incidence
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Radiology Nuclear Medicine and imaging

Cite this

@article{a46703fde0ae4b69b53ebccbe83e0b60,
title = "Can Discrepancies Between Coronary Computed Tomography Angiography and Cardiac Catheterization in High-Risk Patients be Overcome With Consensus Reading?",
abstract = "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.",
author = "Sharon Steinberger and Plodkowski, {Andrew J.} and Larry Latson and Levsky, {Jeffrey M.} and Benjamin Zalta and Alla Godelman and Cohen, {Hillel W.} and Haramati, {Linda B.}",
year = "2016",
month = "8",
day = "25",
doi = "10.1097/RCT.0000000000000481",
language = "English (US)",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",

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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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