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High Intracoronary Attenuation Improves Accuracy of 64-slice CT-CA

High intracoronary attenuation significantly improves diagnostic accuracy in 64-slice CT-CA of the coronary arteries, according to a new study by researchers from Erasmus Medical Center in Rotterdam, The Netherlands and Azienda Ospedaliero-Universitaria in Parma, Italy.

For the study, 170 patients with suspected coronary artery disease underwent CT-CA. The average vascular attenuation measured in the aortic root and in coronary arteries was used to divide the population into two groups of 85 patients each, one with low attenuations and one with high. The researchers found that the sensitivity and specificity for detecting artery lesions were 91% and 93%, respectively, for the low group and 96% and 97%, respectively for the high attenuation group.

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“These results stress the importance of high intra-coronary attenuation during coronary CT angiography to achieve better diagnostic accuracy and therefore better diagnosis,” said Filippo Cademartiri, MD, of Erasmus Medical Center, and one of the authors of the study. “As a result, a higher iodine concentration could be a means to increase diagnostic accuracy,” he added.

However, the authors caution, high attenuation by itself is not the only issue that should be taken into consideration. “Other factors beside high attenuation are also important, especially in difficult patients (for instance, high body mass index, small coronary arteries, etc.). This information can be the difference between a diagnostic and a non-diagnostic investigation,” said Dr. Cademartiri.

The full results of the study will be presented on Monday, May 7 by Erica Maffei, MD, of the Azienda Ospedaliero-Universitaria, during the American Roentgen Ray Society Annual Meeting in Orlando, FL.

(SOURCES: Society of Nuclear Medicine, news release, June 7, 2006)

WEDNESDAY, June 7 (HealthDay News) -- New, noninvasive technology may give doctors a leg up on diagnosing and treating coronary artery disease.

An Israeli study showed that using single photon emission computed tomography (SPECT) in combination with computed tomography coronary angiography (CTCA) provides more accurate results when screening for heart disease.

SPECT is commonly used to diagnose coronary lesions in patients experiencing chest pain, while CTCA is a relatively new technique used to diagnose coronary stenosis, or narrowing of the blood vessels.

"This work presents a new, noninvasive cardiac imaging technology for the assessment of ischemic heart disease -- also known as coronary artery or coronary heart disease -- caused by the narrowing of heart arteries, which prevents blood and oxygen from reaching the heart muscle," Zohar Keidar, deputy director of the nuclear medicine department at Rambam HealthCare Campus in Haifa, Israel, said in a prepared statement.

"This new modality enables -- in a single imaging session -- accurate evaluation of cardiac blood vessel narrowing and blood supply to the heart muscles," Keidar said.

Using these two technologies together provides a more accurate view of a patient's blood flow to the heart than using either of these tests alone, the study results indicate.

"These initial results indicate that cardiac SPECT/CT imaging enables the precise localization of an abnormal ischemic segment of the cardiac muscle to the responsible blood vessel, thus indicating if one or more coronary arteries are obstructed and can and should be treated," said Keidar. "On the other hand, the combined information can also demonstrate that a narrowed blood vessel has no significant impact on patient's heart perfusion, thus eliminating the need for further invasive treatment."

Results of the study were released Wednesday at the Society of Nuclear Medicine's annual meeting, in San Diego.

Keidar added that additional research on certain types of patients, including those with diabetes and those who have experienced other cardiac events, is still needed.

"Combining SPECT with CT is a significant advance," said Josef Machac, cardiovascular vice chair of the Society of Nuclear Medicine's Scientific Program Committee. "This work provides a more accurate picture of the severity of coronary artery disease."

More information

Find out more about coronary artery disease from the Cleveland Clinic's Heart & Vascular Institute.