BMC Medical Imaging
|
Viewing options:Associated material:Related literature:- Articles citing this article
- Other articles by authors
- Related articles/pages
Tools:Post to:
|
Research articleMultidetector computed tomography angiography for assessment of in-stent restenosis: meta-analysis of diagnostic performancePiet K Vanhoenacker1* , Isabel Decramer1,2* , Olivier Bladt1 , Giovanna Sarno2 , Erik Van Hul1 , William Wijns2 and Ben A Dwamena3  1
Department of Radiology and Imaging, OLV Ziekenhuis, Aalst, Belgium 2
Cardiovascular Center Aalst, Aalst, Belgium 3
Division of Nuclear Medicine, Department of Radiology, University of Michigan Health System, Ann Arbor, USA author email corresponding author email* Contributed equally
BMC Medical Imaging 2008,
8:14doi:10.1186/1471-2342-8-14 Abstract
Background
Multi-detector computed tomography angiography (MDCTA)of the coronary arteries after stenting has been evaluated in multiple studies.
The purpose of this study was to perform a structured review and meta-analysis of the diagnostic performance of MDCTA for the detection of in-stent restenosis in the coronary arteries.
Methods
A Pubmed and manual search of the literature on in-stent restenosis (ISR) detected on MDCTA compared with conventional coronary angiography (CA) was performed. Bivariate summary receiver operating curve (SROC) analysis, with calculation of summary estimates was done on a stent and patient basis. In addition, the influence of study characteristics on diagnostic performance and number of non-assessable segments (NAP) was investigated with logistic meta-regression.
Results
Fourteen studies were included. On a stent basis, Pooled sensitivity and specificity were 0.82(0.72–0.89) and 0.91 (0.83–0.96). Pooled negative likelihood ratio and positive likelihood ratio were 0.20 (0.13–0.32) and 9.34 (4.68–18.62) respectively. The exclusion of non-assessable stents and the strut thickness of the stents had an influence on the diagnostic performance. The proportion of non-assessable stents was influenced by the number of detectors, stent diameter, strut thickness and the use of an edge-enhancing kernel.
Conclusion
The sensitivity of MDTCA for the detection of in-stent stenosis is insufficient to use this test to select patients for further invasive testing as with this strategy around 20% of the patients with in-stent stenosis would be missed. Further improvement of scanner technology is needed before it can be recommended as a triage instrument in practice. In addition, the number of non-assessable stents is also high. |