Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

• Published in: European journal of radiology 2010-02, Vol.73 (2), p.266-273
• Main Authors: Sun, Zhonghua, Almutairi, Abdulrahman Marzouq D
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Cardiovascular system; Coronary Angiography - utilization; Coronary artery disease; Coronary heart disease; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - epidemiology; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - epidemiology; Heart; Humans; Incidence; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Multislice computed tomography; Prognosis; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Reproducibility of Results; Restenosis; Risk Assessment - methods; Risk Factors; Sensitivity and Specificity; Stent; Tomography, X-Ray Computed - utilization
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2008.10.025

Abstract Purpose The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography. Materials and methods A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model. Results Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography. Conclusion Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.