Detection of Coronary Artery Diseases: Comparative Study of Multidetector Computed Tomography Angiogram (64 slice scanner) and Conventional Angiogram

Background: Multislice computed tomography (MDCT) is a promising noninvasive method of detecting coronary artery disease. It is not yet being widely used in Bangladesh. We aimed to assess the diagnostic accuracy of the of 64 slice CT in detecting CAD with reference to conventional coronary angiography. Methods: It was cross sectional comparative study conducted in National Institute of Cardiovascular Diseases and Bangabandhu Sheikh Mujib Medical University. Total 80 patients were included in the study who underwent MDCT and coronary angiogram. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for single vessel disease were 87.5%, 96.4%, 91.3%, 94.7% and 93.75% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for double vessel disease were 84.0%, 94.5%, 87.5%, 92.85% and 91.25% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for triple vessel disease were 69.5%, 91.22%, 76.19%, 88.13% and 85.0% respectively. Conclusion: Coronary angiography is a promising technology that already appears to have high performance to assess patient base, vessel base and segment base sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detecting coronary artery stenosis. DOI: http://dx.doi.org/10.3329/cardio.v4i2.10455 Cardiovasc. j. 2012; 4(2): 120-126

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Can 64-Row Computed Tomography Replace Angiography after Coronary Bypass?

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230801600603 ◽

2008 ◽

Vol 16 (6) ◽

pp. 444-449 ◽

Cited By ~ 2

Author(s):

Hirosato Doi ◽

Ryuji Koshima ◽

Masato Suzuki ◽

Ken Takahashi ◽

Hiroichi Yokoyama ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Coronary Angiography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Artery Bypass ◽

Graft Occlusion ◽

Diagnostic Power ◽

Multi Detector Computed Tomography

Multi-detector (64-row) computed tomography has become an alternative to coronary angiography to diagnose graft occlusion and stenosis after coronary artery bypass. We compared the power of evaluation of multi-detector computed tomography with that of conventional coronary angiography in 60 patients who underwent coronary artery bypass with 135 grafts and 210 graft anastomoses. The diagnostic power of multi-detector computed tomography for graft occlusion was: 100% (2/2) sensitivity, 98.5% (131/133) specificity, 50% (2/4) positive predictive value, and 100% (133/133) negative predictive value; there were no significant differences in rates of occlusion among the different types of graft. The diagnostic power of multi-detector computed tomography for stenosis of the graft anastomosis was: 100% (2/2) sensitivity, 95.1% (194/204) specificity, 16.6% (2/12) positive predictive value, and 100% (194/194) negative predictive value, with no significant differences among grafts. Multi-detector computed tomography permits evaluation of bypass grafts and is much less invasive for the patients.

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Abstract 5803: Optimal Threshold for Multi Detector Computer Tomography to Detect Physiologically Significant Stenosis in Patients with Ischemic Heart Disease

Circulation ◽

10.1161/circ.118.suppl_18.s_106-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Takashi Yamano ◽

Atsushi Tanaka ◽

Takashi Tanimoto ◽

Shigeho Takarada ◽

Hiroki Kitabata ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Optimal Threshold ◽

Fractional Flow ◽

Significant Stenosis ◽

Artery Disease

PURPOSE: Sixty-four multi detector computed tomography angiography (64-MDCT) has emerged as a rapidly developing method for the noninvasive detection of coronary artery disease with high negative predictive value and relatively low positive predictive value, especially in patients with intermediate-severity coronary artery disease (ISCAD). There are, however, few studies regarding with optimal threshold for detection of physiologically significant stenosis in 64-MDCT. The purpose of this study was to investigate the optimal threshold for 64-MDCT to detect physiologically significant stenosis using fractional flow reserve of the myocardium (FFRmyo) in patients with ISCAD. METHODS: We enrolled single lesions detected by 64-MDCT of 64 ISCAD patients (age, 68.3 +/− 10.2 years; 78% male). FFRmyo </= 0.75 measured by a 0.014-inch pressure wire was used as the gold standard for presence of physiologically significant stenosis. The area stenosis (%AS) in 64-MDCT were compared with the results of FFRmyo and percent diameter stenosis (%DS) in quantitative coronary angiography (QCA) during elective coronary angiography. Using receiver operating characteristic (ROC) analysis, the optimum threshold for percent area stenosis (%AS) in 64-MDCT was determined in the prediction of FFRmyo </= 0.75. RESULTS: There was an inverse correlation between %AS in 64-MDCT and FFRmyo (65 +/− 20 % and 0.71 +/− 0.16, respectively; r = −0.67; p < 0.01). Furthermore, there was a positive correlation between %AS in 64-MDCT and %DS in QCA (65 +/− 20 % and 63 +/− 19 %, respectively; r = 0.69; p < 0.01). Using a cutoff of 62 %AS in 64-MDCT, ROC curve analysis shows 79 % sensitivity, 85 % specificity, 82% positive predictive value, 83% negative predictive value and 83% accuracy for detecting physiologically significant stenosis. CONCLUSION: > 62 %AS in 64-MDCT could predict the physiologically significant coronary stenosis in patients with ISCAD. Applying an alternative threshold to detect physiologically significant stenosis might contribute to improve the diagnostic accuracy for 64-MDCT in patients with ISCAD.

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Comparison of Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value of Stress Testing Versus 64-Multislice Coronary Computed Tomography Angiography in Predicting Obstructive Coronary Artery Disease Diagnosed by Coronary Angiography

The American Journal of Cardiology ◽

10.1016/j.amjcard.2007.10.044 ◽

2008 ◽

Vol 101 (6) ◽

pp. 774-775 ◽

Cited By ~ 32

Author(s):

Gautham Ravipati ◽

Wilbert S. Aronow ◽

Hoang Lai ◽

John Shao ◽

Albert J. DeLuca ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Predictive Value ◽

Stress Testing ◽

Coronary Computed Tomography Angiography ◽

Obstructive Coronary Artery Disease ◽

Artery Disease ◽

Sensitivity Specificity

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Detection of local failures after management of nasopharyngeal carcinoma: a prospective, controlled trial

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002016 ◽

2008 ◽

Vol 122 (11) ◽

pp. 1230-1234 ◽

Cited By ~ 10

Author(s):

S M Ragab ◽

F A Erfan ◽

M A Khalifa ◽

E M Korayem ◽

H A Tawfik

Keyword(s):

Computed Tomography ◽

Nasopharyngeal Carcinoma ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

External Beam Radiotherapy ◽

Reliability Coefficient ◽

Histological Findings ◽

Significant Agreement ◽

Sensitivity Specificity

AbstractObjectives:To conduct a prospective study (1) to evaluate and compare the efficacies of nasopharyngeal endoscopy and computed tomography in the diagnosis of local failure of external beam radiotherapy for nasopharyngeal carcinoma, and (2) to assess whether multiple endoscopic nasopharyngeal biopsies are superior to a single, targeted biopsy, for the same purpose.Methods:Forty-six patients who had been treated with external beam radiotherapy for primary nasopharyngeal carcinoma were enrolled in the study. For every patient recruited, computed tomography, rigid nasopharyngeal endoscopy and nasopharyngeal biopsies were performed 12 weeks after radiotherapy.Results:Twelve weeks after treatment, six patients (13 per cent) had evident disease on histological examination of biopsies. Nasopharyngeal endoscopy showed a sensitivity, specificity, positive predictive value and negative predictive value of 66.6, 95, 66.6 and 95 per cent, respectively. There was statistically significant agreement between the endoscopic findings and the histological findings (Kappa reliability coefficient = 0.617, p < 0.01). Computed tomography showed a sensitivity, specificity, positive predictive value and negative predictive value of 50, 45, 12 and 85.7 per cent, respectively. There was no statistically significant agreement between the computed tomography findings and the histological findings (Kappa reliability coefficient = 0.021, p > 0.05). A targeted, single biopsy performed under endoscopic control demonstrated excellent sensitivity, specificity, positive predictive value and negative predictive value, being 83.3, 100, 100 and 97.5 per cent, respectively. The Kappa test showed a very statistically significant agreement between the histological findings for the single and the multiple endoscopic biopsies (Kappa reliability coefficient = 0.897, p < 0.001).Conclusions:Rigid nasopharyngeal endoscopy should be considered the primary follow-up tool after radiotherapy treatment of nasopharyngeal carcinoma, with computed tomography being reserved for patients with histological or symptomatic indications. Routine postnasal biopsies are not necessary, given the excellent specificity and negative predictive value of rigid nasopharyngeal endoscopy. Single, targeted endoscopic biopsy provides an excellent alternative to the usual multiple biopsies. In addition, it reduces cost, time, morbidity and patient discomfort.

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Computed tomography versus ureteroscopy in identification of renal tract stone with ureteral stent in situ

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x13165261993996 ◽

2011 ◽

Vol 93 (8) ◽

pp. 639-641 ◽

Cited By ~ 4

Author(s):

VCY Tang ◽

A Attwell-Heap

Keyword(s):

Computed Tomography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Ureteral Stent ◽

The Difference ◽

Contrast Ct ◽

Sensitivity Specificity

INTRODUCTION The aim of this study was to validate the use of non-contrast computed tomography (CT) with a ureteral stent in situ instead of ureteroscopy for identification of renal tract stones. METHODS All patients who had stents inserted for renal tract stones and underwent non-contrast CT with the stent in situ followed by ureteroscopy between May 2008 and October 2009 at The Canberra Hospital, Australia, were analysed retrospectively. Statistical analysis was performed to compare any differences between CT and ureteroscopy in the identification of stones. RESULTS Overall, 57 patients were included in the study. The difference between CT and ureteroscopy findings was statistically significant. CT identification of stones with a stent in situ had a sensitivity of 86%, a specificity of 46%, a positive predictive value of 63%, a negative predictive value of 76% and an accuracy of 67%. CONCLUSIONS Our study suggests that non-contrast CT is inferior to the ‘gold standard’ of ureteroscopy. It lacks sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Therefore, we cannot recommend using non-contrast CT to replace ureteroscopy.

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Accuracy of Ultrasound Scanning in Diagnosing Acute Appendicitis in Patients Admitted at Vicente Sotto Memorial Medical Center

Journal of Karnali Academy of Health Sciences ◽

10.3126/jkahs.v3i2.31325 ◽

2020 ◽

Vol 3 (2) ◽

pp. 134-139

Author(s):

Uma Gurung ◽

Dhiraj Gurung

Keyword(s):

Computed Tomography ◽

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Medical Center ◽

Diagnostic Tools ◽

Advantages And Disadvantages ◽

Sensitivity Specificity ◽

Suspected Acute Appendicitis

Introduction: Acute appendicitis is the most common abdominal surgical emergency. Both abdominal ultrasonography and computed tomography are common diagnostic tools in its diagnosis with each having its own advantages and disadvantages. Methods: Patients of suspected acute appendicitis were evaluated with an ultrasound to see the sensitivity, specificity, positive and negative predictive value of ultrasound for intraoperative appendicitis diagnosis. The study included 113 patients of suspected acute appendicitis presenting in the emergency during a one year duration. Sensitivity, specificity, positive predictive value and negative predictive value was calculated from their respective formulae. Results: The majority of the patients were male patients between the age group of 18 to 30. The sensitivity of ultrasound for diagnosis of acute appendicitis was 96% and specificity was 33%. The positive predictive value was 98% and the negative predictive value was 20% Conclusion: Ultrasound has good sensitivity and the low cost along with no radiation exposure makes this an acceptable screening investigative modality though due to low specificity, it would be recommended to go for a computed tomography scan if ultrasound shows negative result for appendicitis.

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Dual-energy computed tomography for the diagnosis of acute gouty arthritis

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210707164124 ◽

2021 ◽

Vol 17 ◽

Author(s):

Zengfa Huang ◽

Zuoqin Li ◽

Jianwei Xiao ◽

Yuanliang Xie ◽

Yun Hu ◽

...

Keyword(s):

Computed Tomography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Gouty Arthritis ◽

Dual Energy ◽

Multicenter Studies ◽

Acute Gouty Arthritis ◽

Dual Energy Computed Tomography ◽

Sensitivity Specificity

Aims: To investigate the diagnostic value of dual-energy computed tomography (DECT) in acute gouty arthritis (AGA) or patients presenting with suspected gouty arthritis. Methods: This retrospective study was performed in a single centre from May 2017 to August 2018. Two hundred and twenty-six patients with an initial diagnosis of AGA in the preceding 15 days were included. All patients were referred for a DECT scan of the affected joints. The diagnosis criteria of gout with the American College of Rheumatology Classification Standard were regarded as the reference standard. Results: Two hundred patients were included in the present study at last. The sensitivity, specificity, positive predictive value, and negative predictive value of DECT in the diagnosis of all AGA were 83.83%, 60.61%, 91.5% and 42.55% respectively. When AGA was subdivided according to the joint site, the sensitivity, specificity, positive predictive value, and negative predictive value were 80.68%, 61.11%, 91.03%, and 39.29% in feet, 93.55%, 40%, 93.55%, and 40% in knees and 87.5%, 71.43%, 91.3%, and 62.5% in ankles, respectively. Conclusions: DECT had a high sensitivity for the diagnosis of AGA. However, the specificity was limited, particularly for the diagnosis of acute gouty knee arthritis. Prospective multicenter studies of large samples will enhance the application of DECT among the AGA patients in the future.

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Accuracies of Diagnostic Methods for Acute Appendicitis

The American Surgeon ◽

10.1177/000313481307900138 ◽

2013 ◽

Vol 79 (1) ◽

pp. 101-106 ◽

Cited By ~ 21

Author(s):

Jong Seob Park ◽

Jin Ho Jeong ◽

Jong In Lee ◽

Jong Hoon Lee ◽

Jea Kun Park ◽

...

Keyword(s):

Computed Tomography ◽

Acute Appendicitis ◽

Positive Predictive Value ◽

Physical Examination ◽

Negative Predictive Value ◽

Predictive Value ◽

Negative Appendectomy ◽

Pathologic Findings ◽

Negative Appendectomy Rate ◽

Sensitivity Specificity

The objectives were to evaluate the effectiveness of ultrasonography, computed tomography, and physical examination for diagnosing acute appendicitis with analyzing their accuracies and negative appendectomy rates in a clinical rather than research setting. A total of 2763 subjects were enrolled. Sensitivity, specificity, positive predictive value, and negative predictive value and negative appendectomy rate for ultrasonography, computed tomography, and physical examination were calculated. Confirmed positive acute appendicitis was defined based on pathologic findings, and confirmed negative acute appendicitis was defined by pathologic findings as well as on clinical follow-up. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 99.1, 91.7, 96.5, and 97.7 per cent, respectively; for computed tomography, 96.4, 95.4, 95.6, and 96.3 per cent, respectively; and for physical examination, 99.0, 76.1, 88.1, and 97.6 per cent, respectively. The negative appendectomy rate was 5.8 per cent (5.2% in the ultrasonography group, 4.3% in the computed tomography group, and 12.2% in the physical examination group). Ultrasonography/computed tomography should be performed routinely for diagnosis of acute appendicitis. However, in view of its advantages, ultrasonography should be performed first. Also, if the result of a physical examination is negative, imaging studies after physical examination can be unnecessary.

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Acute Appendicitis - Study of Role of Ultrasound and CT Scan in Decision Making for Surgery in a Tertiary Care Government Hospital in Eastern India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/556 ◽

2021 ◽

Vol 8 (33) ◽

pp. 3048-3053

Author(s):

Jainendra Kumar ◽

Akriti Komal

Keyword(s):

Computed Tomography ◽

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Imaging Modality ◽

Tertiary Care ◽

Accurate Diagnosis ◽

Final Decision ◽

Sensitivity Specificity

BACKGROUND Acute appendicitis (AA) is one of the commonest causes of acute abdominal emergencies. Accurate diagnosis and earlier surgery is imperative in such cases. Ultrasonography (US), and computed tomography (CT), are main stays accurate diagnosis of this disease. This study was conducted to compare the accuracy of US and CT in the diagnosis of AA and reduce number of negative appendectomies. METHODS This prospective study was done after approval from institutional ethical committee and obtaining written consent. 164 patients with clinical features suggestive of AA, were selected from emergency department of Patna Medical College, Patna India during the period from January 2019 to December 2020. 98 were males and 66 females, mean age being 18.08 years. 142 patents (86.58 %) underwent surgery, and 22 patients (13.41 %) were kept on clinical observation in hospital after imaging. After detailed clinical workup and laboratory investigations, all patients were subjected to both US and CT examination. Each patient was reevaluated clinically, and a clinical correlation was done between both sets of results. Based on these, final decision was made. Accuracy was decided based on intra-operative findings in appendectomy group and were correlated with imaging findings later with histopathologic findings. RESULTS Males outnumbered females, abdominal pain was present in 100%. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US in diagnosis of AA in our study were 92.6 %, 76.4 %, 95.3%, 71.0% and 88.9 % respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of CT in diagnosis of AA were 99.1 %, 90.5 %, 98.6%, 87.8% and 97.8 % respectively. CONCLUSIONS US should be the first-line imaging modality as it is free from radiation. CT is recommended as additional imaging tool to raise accuracy in diagnosis except in pregnancy and selected pediatric patients. KEYWORDS Acute Appendicitis, Computed Tomography, Ultrasound

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Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

The Heart Surgery Forum ◽

10.1532/hsf98.20111075 ◽

2012 ◽

Vol 15 (1) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Levent Sahiner ◽

Ali Oto ◽

Kudret Aytemir ◽

Tuncay Hazirolan ◽

Musturay Karcaaltincaba ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Diagnostic Accuracy ◽

Multidetector Computed Tomography ◽

Coronary Artery Bypass ◽

Predictive Value ◽

Artery Bypass ◽

Time Interval ◽

Mdct Angiography ◽

Sensitivity Specificity

Background: The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).Methods: Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.Results: Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.Conclusion: Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.

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