Efficacy of computer aided analysis in detection of significant coronary artery stenosis in cardiac using dual source computed tomography

Abstract

Objective: To analyze the diagnostic efficacy of computer aided analysis of relevant coronary artery stenosis using dual source computed tomography (DSCT).

Methods: In a larger scale study patients scheduled for conventional coronary angiography (CA) were additionally examined with DSCT. Based on a 13-segment model 30 CT scans of this study population were analyzed for significant stenosis using conventional 3D charts (3D) as well as a specialized cardiac analysis tool (CAT). Diagnostic accuracy and time to diagnosis was recorded for each vessel separately as well as the three readers' confidence.

Results: With severe coronary artery calcifications, 53 false interpretations of segments were found for the total of 390 coronary segments analyzed. 3D and CAT analysis showed a Sensitivity, Specificity, PPV and NPV of 0.59, 0.91, 0.57, 0.92 and 0.57, 0.92, 0.56, 0.92, respectively. No significant differences in diagnostic accuracy could be found between 3D and CAT (P = 0.1667). 3D took a mean of 5.2 min (3-10 min). With CAT a mean time of 8.2 min (4-12 min) was needed. No significant inter-reader time differences (P = 0.4954) and no significant confidence level differences were found between readers and analyzes.

Conclusion: CAT of the coronary tree shows comparable accuracy to manual 3D analysis but needs improvements concerning coronary tree segmentation times.