Photon-counting detector CT reduces the rate of referrals to invasive coronary angiography as compared to CT with whole heart coverage energy-integrating detector.

Simon, Judit; Hrenkó, Áron; Kerkovits, Nóra Melinda; Nagy, Kristóf; Vértes, Miklós; Balogh, Hanna; Nagy, Norbert; Munkácsi, Tamás; Emrich, Tilman; Varga-Szemes, Akos; Boussoussou, Melinda; Vattay, Borbála; Vecsey-Nagy, Milán; Kolossváry, Márton; Szilveszter, Bálint; Merkely, Béla; Maurovich-Horvat, Pál

Simon, Judit; Hrenkó, Áron; Kerkovits, Nóra Melinda; Nagy, Kristóf; Vértes, Miklós; Balogh, Hanna; Nagy, Norbert; Munkácsi, Tamás; Emrich, Tilman; Varga-Szemes, Akos; Boussoussou, Melinda; Vattay, Borbála; Vecsey-Nagy, Milán; Kolossváry, Márton; Szilveszter, Bálint; Merkely, Béla; Maurovich-Horvat, Pál.

Afiliação

Simon J; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Hrenkó Á; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Kerkovits NM; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Nagy K; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Vértes M; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Balogh H; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Nagy N; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Munkácsi T; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary.
Emrich T; Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Varga-Szemes A; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Boussoussou M; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Vattay B; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Vecsey-Nagy M; Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Kolossváry M; Gottsegen National Cardiovascular Center, Budapest, Hungary; Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Hungary.
Szilveszter B; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Merkely B; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Maurovich-Horvat P; MTA-SE Cardiovascular Imaging Research Group, Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary. Electronic address: maurovich-horvat.pal@semmelweis.hu.

J Cardiovasc Comput Tomogr ; 18(1): 69-74, 2024.

Article em En | MEDLINE | ID: mdl-38097408

ABSTRACT

ABSTRACT

BACKGROUND:

We sought to compare the degree of maximal stenosis and the rate of invasive coronary angiography (ICA) recommendations in patients who underwent coronary CT angiography (CCTA) with photon-counting detector CT (PCD-CT) versus those who underwent CCTA with whole heart coverage energy-integrating detector CT (EID-CT).

METHODS:

In our retrospective single-center study, we included consecutive patients with suspected CAD who underwent CCTA performed with either PCD-CT or a 280-slice EID-CT. The degree of coronary stenosis was classified as no CAD, minimal (1-24 â%), mild (25-49 â%), moderate (50-69 â%), severe stenosis (70-99 â%), or occlusion.

RESULTS:

A total of 812 consecutive patients were included in the analysis, 401 patients scanned with EID-CT and 411 patients with PCD-CT (mean age 58.4 â± â12.4 years, 45.4 â% female). Despite the higher total coronary artery calcium score (CACS) in the PCD-CT group (10 [interquartile range (IQR) â= â0-152.8] vs 1 [IQR â= â0-94], p â< â0.001), obstructive CAD was more frequently reported in the EID-CT vs PCD-CT group (no CAD 28.7 â% vs 26.0 â%, minimal 23.2 â% vs 30.9 â%, mild 19.7 â% vs 23.4 â%, moderate 14.5 â% vs 9.7 â%, severe 11.5 â% vs 8.5 â% and occlusion 2.5 â% vs 1.5 â%, respectively, p â= â0.025). EID-CT was independently associated with downstream ICA (OR â= â2.76 [95%CI â= â1.58-4.97] p â< â0.001) in the overall patient population, in patients with CACS<400 (OR â= â2.18 [95%CI â= â1.13-4.39] p â= â0.024) and in patients with CACS≥400 (OR â= â3.83 [95%CI â= â1.42-11.05] p â= â0.010).

CONCLUSION:

In patients who underwent CCTA with PCD-CT the number of subsequent ICAs was lower as compared to patients who were scanned with EID-CT. This difference was greater in patients with extensive coronary calcification.

Assuntos

Angiografia por Tomografia Computadorizada; Tomografia Computadorizada por Raios X; Humanos; Feminino; Pessoa de Meia-Idade; Idoso; Masculino; Angiografia Coronária; Estudos Retrospectivos; Constrição Patológica; Estudos Prospectivos; Valor Preditivo dos Testes; Encaminhamento e Consulta; Imagens de Fantasmas

Palavras-chave

Coronary artery disease; Coronary computed tomography angiography; High calcium score; Photon-counting detector computed tomography

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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tomografia Computadorizada por Raios X / Angiografia por Tomografia Computadorizada Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

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