Diagnostic performance of coronary angiography utilizing intraprocedural 320-row computed tomography with minimal contra
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ORIGINAL ARTICLE
Diagnostic performance of coronary angiography utilizing intraprocedural 320‑row computed tomography with minimal contrast medium Misato Chimura1 · Tomohito Ohtani1 · Kensuke Yokoi1 · Tatsuya Shiraki1 · Themistoklis Katsimichas1,2 · Takashi Kitao3 · Masaki Awata4 · Isamu Mizote1 · Shungo Hikoso1 · Satoru Sumitsuji5 · Yasushi Sakata1 Received: 10 December 2019 / Accepted: 17 April 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract Recently developed coronary angiography with intraprocedural 320-row computed tomography can be performed in a catheterization laboratory (XACT) by injecting contrast medium from a place close to the coronary arteries, thereby requiring a minimal amount of contrast medium. However, its clinical application has not yet been established. This study aimed to evaluate the diagnostic accuracy of XACT angiography with a minimal volume of contrast medium in patients with suspected coronary artery disease (CAD). A total of 167 coronary segments were analyzed in 14 patients (9 males, median age 70 years) with suspected CAD by XACT angiography with 7.5 ml of contrast medium and invasive coronary angiography (ICA) with standard techniques. The segmental-based diagnostic accuracy of XACT angiography in detecting stenosis of ≥ 50% and ≥ 75% and visualized by ICA was good (sensitivity: 74% and 62%, specificity: 99% and 99%, positive predictive value: 93% and 80%, and negative predictive value: 97% and 97%, respectively). These results suggest that XACT angiography with a very low amount of contrast medium may have strong clinical utility for screening coronary arteries in patients with renal dysfunction or undergoing clinical procedures such as pacemaker implantation. Keywords Coronary angiography · Computed tomography · Low contrast medium · Coronary artery disease
Introduction Recently, an angiographic system with a ceiling-suspended C-arm and 320-row computed tomography imaging capability (XACT) has become available in the catheterization laboratory (INFX-8000 C/AquilionONE Vision Edition; Toshiba Medical Systems Corporation, Otawara, Japan) (Fig. 1). This * Tomohito Ohtani [email protected]‑u.ac.jp 1
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2‑2 Yamadaoka, Suita 565‑0871, Japan
2
1st Cardiology Department, Athens Medical School, Hippokration General Hospital, Athens, Greece
3
Minoh City Hospital, Minoh, Japan
4
Monbetsu General Hospital, Monbetsu, Japan
5
Department of Cardiology for International Education and Research, Osaka University Graduate School of Medicine, Suita, Japan
newly developed system will have various potential applications such as evaluation of the coronary arteries, cardiac structure, or catheter location anatomically and functionally with angiography or computed tomography (CT) in the catheterization laboratory [1]. As compared to CT angiography that uses systemically administered radiographic contrast medium, XACT angiography has the advantage of reduced contrast medium dos
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