Alessandro Napoli MD, Presenter: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Beatrice Cavallo Marincola, Abstract Co-Author: Nothing to Disclose

Chiara Zini, Abstract Co-Author: Nothing to Disclose

Francesca Antonella Calabrese MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

To detect total atherosclerotic vascular burden using a 64-WBCTA protocol based on combined imaging of coronary and systemic arteries.

52 patients with coronary artery disease underwent WBCTA for the evaluation of the entire arterial system. Two image data sets were acquired using a 64x0.6mm detector configuration with an adapted injection protocol. Coronary artery and whole body arterial districts were divided into 16 and 32 segments, respectively. Coronary angiography (QCA) performed within 20 days was the reference standard for determination of diagnostic performance. Detection of significant (≥50%) coronary stenosis was assessed per-artery, per-segment and per-patient. Coronary arteries were classified as having significant disease (≥50% diameter reduction) or no significant disease (<50%). Images were assessed independently by two readers.

Overall 161/780 (20%) segments had stenosis. The sensitivity and specificity of coronary CTA for the detection of significant disease was 78% (125/161) and 94% (584/619) by segment and 90% (62/69) and 93% (81/87) by artery relative to QCA. On a per-patient basis the sensitivity and specificity values were 97% and 82%, respectively. Of 32 patients with multi-coronary involvement, 22 (70%) presented coexisting asymptomatic extra-coronary lesions of whom 9 (28%) had severe segmental arterial stenosis (>75%). Five (30%) of 17 patients with single vessel significant (>75%) stenosis had multi-segmental sub-clinical extracoronary involvement. Nineteen (24%) patients required further work-up for asymptomatic atherosclerotic lesions depicted at WB-CTA.

WB-CTA allows coronary assessment that compares favourably with QCA and provides extra-coronary direct quantification of subclinical lesions. These results support WB-CTA for early atherosclerotic detection and secondary care in this population.

In patients with suspected coronary artery disease, WBCTA represents a promising non-invasive diagnostic tool for comprehensive atherosclerosis assessment and secondary care

Napoli, A, Catalano, C, Cavallo Marincola, B, Zini, C, Calabrese, F, Passariello, R, Clinical Impact of Whole body Computed Tomography Angiography (WB-CTA) in Patients with Suspected Coronary Artery Disease: Incremental Value of Total Atherosclerosis Burden Assessment.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011930.html