The aim of this study was to determine the diagnostic performance of HD-CCTA, in combination with multiple radiation dose reduction strategies, for the detection of obstructive coronary artery disease.
Consecutive patients (N = 43, aged 60 ¡À 10 years, 83 % male) with chest pain and referred for quantitative coronary angiography (QCA) underwent HD-CCTA with radiation dose reduction measures, including prospective electrocardiographic triggering, reduction of additional tube on-time, and minimization of tube voltage and current. Intraluminal diameter stenosis ?50 % was considered significant. QCA served as the reference standard. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate diagnostic accuracy.
All scans demonstrated diagnostic image quality, with 99 % (543/548) of included coronary segments interpretable by HD-CCTA. Median effective radiation dose was 2.8 mSv (interquartile range, 1.3-3.9). The AUC for the per-patient assessment for stenosis ?50 % was 0.90 (95 % confidence interval [CI], 0.77-0.96), with sensitivity of 95 % (95 % CI, 85 % -100 % ), specificity of 79 % (95 % CI, 63 % -95 % ), positive predictive value of 78 % (95 % CI, 61 % -95 % ), and negative predictive value of 95 % (95 % CI, 85 % -100 % ).
Compared with QCA, HD-CCTA with multiple dose reduction measures resulted in low radiation doses and high diagnostic accuracy to detect and exclude obstructive coronary artery disease.