Impact of vessel attenuation on quantitative coronary angiography with 64-slice computed tomography

The aim of the study was to determine the impact of vessel attenuation on quantitative 64-slice computed tomography coronary angiography (CTCA). CTCA and invasive quantitative coronary angiography (QCA) were performed in 100 consecutive patients (42 women, 58 men; mean age 64.4+/-9.4 years; age range 39-87 years). In QCA, stenoses were quantified with dedicated software, whereas in CTCA, stenosis severity was assessed with an electronic caliper tool: stenoses were graded in 10% steps and assigned as either a calcified or non-calcified lesion. Vessel attenuation in the left main (LMA) and the proximal right coronary artery (RCA) were measured and correlated with differences in quantifications of stenosis grade between QCA and CTCA. A total of 113 coronary stenoses were detected by both methods (94 significant and 19 non-significant); 52 stenoses were rated as non-calcified and 61 as calcified lesions. The mean difference between QCA and quantitative CTCA grading was 5.1+/-16.9% (range -27 to 46%) overall; 1.9+/-14.2% (range -27 to 38%) for non-calcified lesions and 7.8+/-18.6% (range -23 to 46%) for calcified lesions. Mean vessel attenuation was 362+/-76 HU (range 191 to 584 HU) in the LMA and 333+/-81 HU (range 162 to 564 HU) in the RCA. Attenuation did not significantly correlate with differences in QCA and CTCA gradings; neither overall, nor for calcified or non-calcified lesions. When 64-slice CTCA is used, coronary vessel attenuation had no impact on the quantitative grading of stenoses. Impact of vessel attenuation on quantitative coronary angiography with 64-slice computed tomography L HUSMANN, MD, O GAEMPERLI, MD, I VALENTA, MD, T SCHEPIS, MD, H SCHEFFEL, MD, P STOLZMANN, MD, S LESCHKA, MD, L DESBIOLLES, MD, B MARINCEK, MD, H ALKADHI, MD and P A KAUFMANN, MD Cardiovascular Center, University Hospital Zurich, Switzerland, Institute of Diagnostic Radiology, University Hospital Zurich, Switzerland and Center for Integrative Human Physiology, University of Zurich, Switzerland ABSTRACT. The aim of the study was to determine the impact of vessel attenuation on quantitative 64-slice computed tomography coronary angiography (CTCA).. CTCA and invasive quantitative coronary angiography (QCA) were performed in 100 consecutive patients (42 women, 58 men; mean age 64.4¡9.4 years; age range 39–87 years). In QCA, stenoses were quantified with dedicated software, whereas in CTCA, stenosis severity was assessed with an electronic caliper tool: stenoses were graded in 10% steps and assigned as either a calcified or non-calcified lesion. Vessel attenuation in the left main (LMA) and the proximal right coronary artery (RCA) were measured and correlated with differences in quantifications of stenosis grade between QCA and CTCA. A total of 113 coronary stenoses were detected by both methods (94 significant and 19 nonsignificant); 52 stenoses were rated as non-calcified and 61 as calcified lesions. The mean difference between QCA and quantitative CTCA grading was 5.1¡16.9% (range 227 to 46%) overall; 1.9¡14.2% (range 227 to 38%) for non-calcified lesions and 7.8¡18.6% (range 223 to 46%) for calcified lesions. Mean vessel attenuation was 362¡76 HU (range 191 to 584 HU) in the LMA and 333¡81 HU (range 162 to 564 HU) in the RCA. Attenuation did not significantly correlate with differences in QCA and CTCA gradings; neither overall, nor for calcified or non-calcified lesions. When 64-slice CTCA is used, coronary vessel attenuation had no impact on the quantitative grading of stenoses. Received 17 March 2008 Revised 2 June 2008 Accepted 16 June 2008 The aim of the study was to determine the impact of vessel attenuation on quantitative 64-slice computed tomography coronary angiography (CTCA).. CTCA and invasive quantitative coronary angiography (QCA) were performed in 100 consecutive patients (42 women, 58 men; mean age 64.4¡9.4 years; age range 39–87 years). In QCA, stenoses were quantified with dedicated software, whereas in CTCA, stenosis severity was assessed with an electronic caliper tool: stenoses were graded in 10% steps and assigned as either a calcified or non-calcified lesion. Vessel attenuation in the left main (LMA) and the proximal right coronary artery (RCA) were measured and correlated with differences in quantifications of stenosis grade between QCA and CTCA. A total of 113 coronary stenoses were detected by both methods (94 significant and 19 nonsignificant); 52 stenoses were rated as non-calcified and 61 as calcified lesions. The mean difference between QCA and quantitative CTCA grading was 5.1¡16.9% (range 227 to 46%) overall; 1.9¡14.2% (range 227 to 38%) for non-calcified lesions and 7.8¡18.6% (range 223 to 46%) for calcified lesions. Mean vessel attenuation was 362¡76 HU (range 191 to 584 HU) in the LMA and 333¡81 HU (range 162 to 564 HU) in the RCA. Attenuation did not significantly correlate with differences in QCA and CTCA gradings; neither overall, nor for calcified or non-calcified lesions. When 64-slice CTCA is used, coronary vessel attenuation had no impact on the quantitative grading of stenoses. Received 17 March 2008 Revised 2 June 2008 Accepted 16 June 2008 DOI: 10.1259/bjr/40319502 ’ 2009 The British Institute of