Background: This study assessed if invasive coronary angiogram (CA) could be replaced by multislice (64- or 256-row) computed tomography (MSCT) to systematically rule out coronary allograft vasculopathy in heart transplant patients.
Methods: Electrocardiogram-gated contrast-enhanced MSCT (64-row for the first 25 patients and 256-row for the others) was compared with CA. MSCT parameters, adapted to the patient's weight, included 120 kV, 800 mAs, 0.625-mm slice thickness, and 0.42/0.27-second rotation time. The primary end point was the negative predictive value (NPV) of MSCT for the detection of significant (>50%) coronary stenosis. Secondary end points were the comparison of X-ray (mSv) and iodine contrast agent (ml) exposures.
Results: The study prospectively included 102 patients (mean age, 53±14 years). Transplantation occurred 6±5 years before inclusion. At CA, 41.8% had stenosis ≤50% and 8% had stenosis>50%. Among the 1,308 angiographic coronary segments ≥1.5 mm, 1,250 (95.6%) were evaluable by MSCT. The NPV of MSCT was 96.6% by patient analysis and 99.7% by segment analysis. The positive predictive value (PPV) was 45.5%. The total volume of contrast agent was 139±43 vs 91±12 vs 56±19 ml (p<0.05) with 64-row MSCT, 256-row MSCT, and CA, respectively. The effective radiation dose was higher using retrospective gating (17.8±5.5 mSv, p<0.05), but similar with prospective gating (6.2±1.9 mSv, p = 0.571) compared with CA (6.0±3.5 mSv).
Conclusion: Newer generations of MSCT (64- or 256-row) have a good NPV and may represent an alternative to invasive CA to rule out significant (>50%) coronary vasculopathy in heart transplant patients, despite a low PPV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.healun.2012.09.008 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development of a CT radiomics prognostic model for post renal tumor resection overall survival based on transformer enhanced K-means clustering.
Med Phys
January 2025
Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Background: Kidney tumors, common in the urinary system, have widely varying survival rates post-surgery. Current prognostic methods rely on invasive biopsies, highlighting the need for non-invasive, accurate prediction models to assist in clinical decision-making.
Purpose: This study aimed to construct a K-means clustering algorithm enhanced by Transformer-based feature transformation to predict the overall survival rate of patients after kidney tumor resection and provide an interpretability analysis of the model to assist in clinical decision-making.
Age determination by measurement of pulp volume of canine teeth in patients with cleft lip and palate: a retrospective study.
Oral Radiol
January 2025
Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul University, Istanbul, Turkey.
Objectives: This study evaluates the potential of pulp volume/total tooth-volume measurements of canine teeth in relation to chronologic age in patients with cleft lip and palate (CLP). The significance of this study lies in its exploration of the usability of these measurements for age determination in CLP patients, providing a novel perspective to the existing literature.
Methods: Cone beam computed tomography images of 33 patients (16 females, 17 males) with unilateral CLP aged 14-45 years and 33 age- and sex-matched healthy individuals (16 females, 17 males) were retrospectively evaluated.
Diagnostic Accuracy of Artificial Intelligence for Detection of Rib Fracture on X-ray and Computed Tomography Imaging: A Systematic Review.
J Imaging Inform Med
January 2025
Department of Orthopedic Surgery, Arrowhead Regional Medical Center, Colton, CA, USA.
Rib pathology is uniquely difficult and time-consuming for radiologists to diagnose. AI can reduce radiologist workload and serve as a tool to improve accurate diagnosis. To date, no reviews have been performed synthesizing identification of rib fracture data on AI and its diagnostic performance on X-ray and CT scans of rib fractures and its comparison to physicians.
View Article and Find Full Text PDFAssessing the Image Quality of Digitally Reconstructed Radiographs from Chest CT.
J Imaging Inform Med
January 2025
Leiden University Medical Center (LUMC), Leiden, the Netherlands.
Rising computed tomography (CT) workloads require more efficient image interpretation methods. Digitally reconstructed radiographs (DRRs), generated from CT data, may enhance workflow efficiency by enabling faster radiological assessments. Various techniques exist for generating DRRs.
View Article and Find Full Text PDFSelective use of ferumoxytol-enhanced magnetic resonance angiography in patients with renal insufficiency: insights from a pilot study.
Int J Cardiovasc Imaging
January 2025
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
The use of conventional contrast agents in computed tomography (CT) and magnetic resonance (MR) imaging is often limited in patients with chronic kidney disease (CKD) due to potential nephrotoxicity. Ferumoxytol, originally developed for iron supplementation, has emerged as a promising alternative MR contrast agent that is safer for patients with CKD. This study aims to present our center's experience with ferumoxytol as a contrast agent in CKD patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!