An update on EBCT (Ultrafast CT) scans for coronary artery disease.

OBJECTIVES To determine the predictive value of electron beam computerized tomographic scans for calcium in the detection of coronary artery disease. DESIGN Literature review and meta-analysis of published studies of electron beam computerized tomographic scans for coronary calcification. METHODS Six studies comparing EBCT scan and coronary angiography findings comprising 2,717 patients were reviewed. Bayesian analyses were performed for the entire cohort and subgroups. Bayesian analyses plots are presented. RESULTS EBCT scans for the detection of coronary artery disease have a sensitivity that ranges from 68% to 100% and a specificity that ranges from 31% to 74% for the presence of significant coronary disease. (Overall, sensitivity = 94%; specifity = 42%) Sensitivities and specificities of EBCT scans for any coronary disease range from 80% to 97% and 52% to 65%, respectively. (Overall, sensitivity = 91%; specificity = 55%). CONCLUSIONS EBCT scans are being performed with increasing frequency as an adjunctive means to diagnose coronary disease. Although EBCT scans are unlikely to ever become a substitute for direct angiographic visualization of the coronary arteries, in certain instances they can be helpful in excluding or increasing the likelihood of significant coronary disease. The results of EBCT scans should be interpreted in the light of other available evidence, including such information as age, sex, the presence of risk factors for coronary disease, and the results of other tests such as ECG stress tests and imaging procedures. In general, although the presence of coronary artery calcification tends to be of more value in indicating that significant coronary disease is not present. The use of Bayesian analyses plots may prove of value in helping determine the significance of EBCT scan findings.