Quantification of coronary stenosis by dual source computed tomography in patients: A comparative study with intravascular ultrasound and invasive angiography

Objective: To determine the accuracy of dual-source CT (DSCT) to quantify coronary stenosis compared to intravascular ultrasound (IVUS) and quantitative coronary angiography (QCA). Methods: 21 patients (23 vessels) were examined with DSCT, IVUS and invasive coronary angiography. Coronary minimal luminal diameter (MLD) and area (MLA) were measured in cross-sectional multiplanar reformatted images perpendicular to the vessel long-axis. The vessel cross-sectional area stenosis (MLA/CSA ratio) was calculated. DSCT results were compared with IVUS and QCA. Results: A good correlation between DSCT and IVUS was noted for diameter and area stenosis (r = 0.69 and r = 0.73), with an overestimation of MLD stenosis by DSCT (+9.1%) and an underestimation of MLA stenosis (-5.8%). For MLD and MLA, high correlation coefficients (r = 0.78 and r = 0.90, respectively) were found between DSCT and IVUS; and the bias was almost zero (-0.41 mm and +0.1 mm(2), respectively). The correlation between DSCT and QCA was moderate (r = 0.60) for MLD stenosis with minor overestimation by DSCT (+4.0%) and moderate (r = 0.59) for MLD (bias, +0.01 mm). The cross-sectional area stenosis showed a moderate correlation (r = 0.59) between DSCT and IVUS (+0.00). Conclusions: DSCT allows accurate quantification of coronary stenosis as compared to IVUS. An excellent correlation was found for the MLA between DSCT and IVUS. (C) 2011 Elsevier Ireland Ltd. All rights reserved.