Evaluation of coronary artery in-stent restenosis by 64-section computed tomography: Factors affecting assessment and accurate diagnosis

Sang Hoon Chung, Young Jin Kim, Jin Hur, Hye Jeong Lee, Kyu Ok Choe, Tae Hoon Kim, Byoung Wook Choi

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17 Citations (Scopus)

Abstract

PURPOSE: To determine factors affecting the ability of 64-multislice computed tomography (MSCT) to detect, assess, and accurately diagnose significant coronary arterial in-stent restenosis (ISR). MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Sixty patients underwent CT coronary angiography using 64-MSCT, after implantation of coronary artery stents (n=91). We assessed diagnostic accuracy for ISR with CT in comparison with conventional coronary angiography as the gold standard, visually and with measurement of in-stent coronary lumen density. Possible factors that influenced the diagnostic performance of CT were evaluated, which included image quality (IQ), stent characteristics, and location. RESULTS: Sixty-nine stents (75.8%) were assessable. Low IQ, location in the left circumflex coronary artery, and narrow stent diameter were associated with poor assessment (P<0.05). In stents that could be assessed, sensitivity, specificity, positive predictive value, and negative predictive value of 64-MSCT were 90.0%, 73.5%, 58.1%, and 94.7%, respectively, for significant ISR. The diagnostic accuracy in assessable stents showed a significant increase with better IQ, thinner strut thickness, and nondrug eluting stent. False-positive diagnoses of ISR by CT were explained by coronary lumen density measurements. CONCLUSIONS: Evaluation of stents by 64-MSCT is not recommended in stents with diameters of ≤2.75 mm or stents located at the left circumflex coronary artery. The diagnostic accuracy of 64-MSCT is affected by IQ and strut thickness in assessable stents. Significant ISR can be excluded with high reliability in selected patients.

Original languageEnglish
Pages (from-to)57-63
Number of pages7
JournalJournal of Thoracic Imaging
Volume25
Issue number1
DOIs
Publication statusPublished - 2010 Feb 1

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Stents
Coronary Vessels
Tomography
Multidetector Computed Tomography
Coronary Angiography
Research Ethics Committees
Informed Consent

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Pulmonary and Respiratory Medicine

Cite this

Chung, Sang Hoon ; Kim, Young Jin ; Hur, Jin ; Lee, Hye Jeong ; Choe, Kyu Ok ; Kim, Tae Hoon ; Choi, Byoung Wook. / Evaluation of coronary artery in-stent restenosis by 64-section computed tomography : Factors affecting assessment and accurate diagnosis. In: Journal of Thoracic Imaging. 2010 ; Vol. 25, No. 1. pp. 57-63.
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abstract = "PURPOSE: To determine factors affecting the ability of 64-multislice computed tomography (MSCT) to detect, assess, and accurately diagnose significant coronary arterial in-stent restenosis (ISR). MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Sixty patients underwent CT coronary angiography using 64-MSCT, after implantation of coronary artery stents (n=91). We assessed diagnostic accuracy for ISR with CT in comparison with conventional coronary angiography as the gold standard, visually and with measurement of in-stent coronary lumen density. Possible factors that influenced the diagnostic performance of CT were evaluated, which included image quality (IQ), stent characteristics, and location. RESULTS: Sixty-nine stents (75.8{\%}) were assessable. Low IQ, location in the left circumflex coronary artery, and narrow stent diameter were associated with poor assessment (P<0.05). In stents that could be assessed, sensitivity, specificity, positive predictive value, and negative predictive value of 64-MSCT were 90.0{\%}, 73.5{\%}, 58.1{\%}, and 94.7{\%}, respectively, for significant ISR. The diagnostic accuracy in assessable stents showed a significant increase with better IQ, thinner strut thickness, and nondrug eluting stent. False-positive diagnoses of ISR by CT were explained by coronary lumen density measurements. CONCLUSIONS: Evaluation of stents by 64-MSCT is not recommended in stents with diameters of ≤2.75 mm or stents located at the left circumflex coronary artery. The diagnostic accuracy of 64-MSCT is affected by IQ and strut thickness in assessable stents. Significant ISR can be excluded with high reliability in selected patients.",
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Evaluation of coronary artery in-stent restenosis by 64-section computed tomography : Factors affecting assessment and accurate diagnosis. / Chung, Sang Hoon; Kim, Young Jin; Hur, Jin; Lee, Hye Jeong; Choe, Kyu Ok; Kim, Tae Hoon; Choi, Byoung Wook.

In: Journal of Thoracic Imaging, Vol. 25, No. 1, 01.02.2010, p. 57-63.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of coronary artery in-stent restenosis by 64-section computed tomography

T2 - Factors affecting assessment and accurate diagnosis

AU - Chung, Sang Hoon

AU - Kim, Young Jin

AU - Hur, Jin

AU - Lee, Hye Jeong

AU - Choe, Kyu Ok

AU - Kim, Tae Hoon

AU - Choi, Byoung Wook

PY - 2010/2/1

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N2 - PURPOSE: To determine factors affecting the ability of 64-multislice computed tomography (MSCT) to detect, assess, and accurately diagnose significant coronary arterial in-stent restenosis (ISR). MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Sixty patients underwent CT coronary angiography using 64-MSCT, after implantation of coronary artery stents (n=91). We assessed diagnostic accuracy for ISR with CT in comparison with conventional coronary angiography as the gold standard, visually and with measurement of in-stent coronary lumen density. Possible factors that influenced the diagnostic performance of CT were evaluated, which included image quality (IQ), stent characteristics, and location. RESULTS: Sixty-nine stents (75.8%) were assessable. Low IQ, location in the left circumflex coronary artery, and narrow stent diameter were associated with poor assessment (P<0.05). In stents that could be assessed, sensitivity, specificity, positive predictive value, and negative predictive value of 64-MSCT were 90.0%, 73.5%, 58.1%, and 94.7%, respectively, for significant ISR. The diagnostic accuracy in assessable stents showed a significant increase with better IQ, thinner strut thickness, and nondrug eluting stent. False-positive diagnoses of ISR by CT were explained by coronary lumen density measurements. CONCLUSIONS: Evaluation of stents by 64-MSCT is not recommended in stents with diameters of ≤2.75 mm or stents located at the left circumflex coronary artery. The diagnostic accuracy of 64-MSCT is affected by IQ and strut thickness in assessable stents. Significant ISR can be excluded with high reliability in selected patients.

AB - PURPOSE: To determine factors affecting the ability of 64-multislice computed tomography (MSCT) to detect, assess, and accurately diagnose significant coronary arterial in-stent restenosis (ISR). MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Sixty patients underwent CT coronary angiography using 64-MSCT, after implantation of coronary artery stents (n=91). We assessed diagnostic accuracy for ISR with CT in comparison with conventional coronary angiography as the gold standard, visually and with measurement of in-stent coronary lumen density. Possible factors that influenced the diagnostic performance of CT were evaluated, which included image quality (IQ), stent characteristics, and location. RESULTS: Sixty-nine stents (75.8%) were assessable. Low IQ, location in the left circumflex coronary artery, and narrow stent diameter were associated with poor assessment (P<0.05). In stents that could be assessed, sensitivity, specificity, positive predictive value, and negative predictive value of 64-MSCT were 90.0%, 73.5%, 58.1%, and 94.7%, respectively, for significant ISR. The diagnostic accuracy in assessable stents showed a significant increase with better IQ, thinner strut thickness, and nondrug eluting stent. False-positive diagnoses of ISR by CT were explained by coronary lumen density measurements. CONCLUSIONS: Evaluation of stents by 64-MSCT is not recommended in stents with diameters of ≤2.75 mm or stents located at the left circumflex coronary artery. The diagnostic accuracy of 64-MSCT is affected by IQ and strut thickness in assessable stents. Significant ISR can be excluded with high reliability in selected patients.

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U2 - 10.1097/RTI.0b013e3181b5d813

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