MSCT may achieve a high level of reliability and accuracy in the visualisation of the coronary arteries. Martin Hoffmann, M.D., of University Hospital, Ulm, Germany and colleagues assessed the diagnostic accuracy of 16-slice MSCT scanning versus invasive coronary angiography in a large group of patients with known or suspected CAD. The study included 103 patients (average age, 61.5 years).The patients underwent both invasive coronary angiography and MSCT using a scanner with 16 detector rows.

The researchers found that compared with invasive coronary angiography for detection of significant lesions (greater than 50 percent stenosis), segment-based sensitivity, specificity, and positive and negative predictive values of MSCT were 95 percent, 98 percent, 87 percent, and 99 percent, respectively.

Quantitative comparison of MSCT and invasive coronary angiography showed good correlation, with MSCT systematically measuring greater-percentage stenoses. Per-patient based analysis indicated high discriminative power to identify patients who might be candidates for revascularisation.

"In conclusion, we found that MSCT shows reasonably high accuracy for detecting significant obstructive CAD when assessed at a patient level. At its current stage of development, it may therefore be used to substantially reduce likelihood of clinically important CAD in patients with suspected disease.

The appeal of MSCT compared with conventional coronary angiography is that it is noninvasive, avoiding most catheter-associated risks and discomforts with the exception of exposure to iodinated contrast agents and radiation. With rapidly improving technology, MSCT may well evolve from a useful complement to invasive angiography to a clinically viable alternative,” the authors write.; Source: American Medical Association (AMA)