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

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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)
Pages (from-to)159-164
Number of pages6
JournalJournal of computer assisted tomography
Volume41
Issue number1
DOIs
StatePublished - 2017

Keywords

  • Consensus reading
  • Coronary CT angiography
  • Coronary artery calcium
  • Coronary artery disease
  • Diagnostic performance

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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