Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis

The aim of this study is to perform a systematic review and meta-analysis of the diagnostic value of 320-slice coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease when compared to invasive coronary angiography. A search of different databases was conducted to id...

Full description

Bibliographic Details
Main Authors: Sun, Zhonghua, Lin, C.
Format: Journal Article
Published: Bentham Science Publishers 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/16660
_version_ 1848749239453089792
author Sun, Zhonghua
Lin, C.
author_facet Sun, Zhonghua
Lin, C.
author_sort Sun, Zhonghua
building Curtin Institutional Repository
collection Online Access
description The aim of this study is to perform a systematic review and meta-analysis of the diagnostic value of 320-slice coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease when compared to invasive coronary angiography. A search of different databases was conducted to identify studies investigating the diagnostic value of 320-slice coronary CT angiography. Sensitivity, specificity, positive and negative predictive value estimates pooled across studies were tested using a fixed effects model and analysed at patient-, vessel- and segment-based assessment. Twelve studies comprising 1592 patients (median, 63 patients, range, 37-240 patients) with a total of 2974 vessels and 21623 segments met selection criteria for inclusion in the analysis. Patients with a high prevalence of coronary artery disease were included in more than 70% of these studies. The mean values and 95% confidence interval (CI) of sensitivity, specificity, positive predictive value and negative predictive value of 320-slice coronary CT angiography were 96.3% (95% CI: 92.9%, 99.8%), 86.4% (95% CI: 77.8%, 94.9%), 89.6% (95% CI: 85.6%, 93.6%) and 93.2% (95% CI: 84.1%, 100%), at patient-based analysis; 91.8% (95% CI: 85.8%, 97.8%), 95.4% (95% CI: 93.6%, 97.1%), 85.9% (95% CI: 79.7%, 92%) and 97.4% (95% CI: 95.9%, 99.1%), at vessel-based analysis; 86.2% (95% CI: 81.8%, 90.6%), 96.5% (95% CI: 95.2%, 98%), 79.9% (95% CI: 75.3%, 84.6%) and 97.8% (95% CI: 96.7%, 99%), at segment-based analysis, respectively. The mean effective dose of 320-slice coronary CT angiography was 10.5 mSv (95% CI: 6.1, 14.8 mSv). Diagnostic value of 320-slice coronary CT angiography was not affected by different heart rates and calcium scores (p>0.05). This analysis shows that 320-slice coronary CT angiography has high diagnostic value in patients with high coronary artery disease prevalence. Relatively high radiation dose is mainly due to inclusion of patients with high heart rates and without using the advanced dose-reduction techniques, thus, further dose-saving strategies should be implemented to minimise the resultant radiation dose.
first_indexed 2025-11-14T07:17:47Z
format Journal Article
id curtin-20.500.11937-16660
institution Curtin University Malaysia
institution_category Local University
last_indexed 2025-11-14T07:17:47Z
publishDate 2014
publisher Bentham Science Publishers
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-166602019-02-19T04:27:23Z Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis Sun, Zhonghua Lin, C. coronary artery disease radiation dose diagnostic value coronary computed tomography angiography The aim of this study is to perform a systematic review and meta-analysis of the diagnostic value of 320-slice coronary computed tomography (CT) angiography in the diagnosis of coronary artery disease when compared to invasive coronary angiography. A search of different databases was conducted to identify studies investigating the diagnostic value of 320-slice coronary CT angiography. Sensitivity, specificity, positive and negative predictive value estimates pooled across studies were tested using a fixed effects model and analysed at patient-, vessel- and segment-based assessment. Twelve studies comprising 1592 patients (median, 63 patients, range, 37-240 patients) with a total of 2974 vessels and 21623 segments met selection criteria for inclusion in the analysis. Patients with a high prevalence of coronary artery disease were included in more than 70% of these studies. The mean values and 95% confidence interval (CI) of sensitivity, specificity, positive predictive value and negative predictive value of 320-slice coronary CT angiography were 96.3% (95% CI: 92.9%, 99.8%), 86.4% (95% CI: 77.8%, 94.9%), 89.6% (95% CI: 85.6%, 93.6%) and 93.2% (95% CI: 84.1%, 100%), at patient-based analysis; 91.8% (95% CI: 85.8%, 97.8%), 95.4% (95% CI: 93.6%, 97.1%), 85.9% (95% CI: 79.7%, 92%) and 97.4% (95% CI: 95.9%, 99.1%), at vessel-based analysis; 86.2% (95% CI: 81.8%, 90.6%), 96.5% (95% CI: 95.2%, 98%), 79.9% (95% CI: 75.3%, 84.6%) and 97.8% (95% CI: 96.7%, 99%), at segment-based analysis, respectively. The mean effective dose of 320-slice coronary CT angiography was 10.5 mSv (95% CI: 6.1, 14.8 mSv). Diagnostic value of 320-slice coronary CT angiography was not affected by different heart rates and calcium scores (p>0.05). This analysis shows that 320-slice coronary CT angiography has high diagnostic value in patients with high coronary artery disease prevalence. Relatively high radiation dose is mainly due to inclusion of patients with high heart rates and without using the advanced dose-reduction techniques, thus, further dose-saving strategies should be implemented to minimise the resultant radiation dose. 2014 Journal Article http://hdl.handle.net/20.500.11937/16660 10.2174/157340561004150121140836 Bentham Science Publishers fulltext
spellingShingle coronary artery disease
radiation dose
diagnostic value
coronary computed tomography angiography
Sun, Zhonghua
Lin, C.
Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title_full Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title_fullStr Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title_full_unstemmed Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title_short Diagnostic value of 320-slice coronary CT angiography in coronary artery disease: A systematic review and meta-analysis
title_sort diagnostic value of 320-slice coronary ct angiography in coronary artery disease: a systematic review and meta-analysis
topic coronary artery disease
radiation dose
diagnostic value
coronary computed tomography angiography
url http://hdl.handle.net/20.500.11937/16660