Diagnostic accuracy of coronary CT angiography using 3rd-generation dual-source CT and automated tube voltage selection: Clinical application in a non-obese and obese patient population.

Abstract

To investigate diagnostic accuracy of 3rd-generation dual-source CT (DSCT) coronary angiography in obese and non-obese patients. We retrospectively analyzed 76 patients who underwent coronary CT angiography (CCTA) and invasive coronary angiography. Prospectively ECG-triggered acquisition was performed with automated tube voltage selection(ATVS). Patients were dichotomized based on body mass index in groups A (<30kg/m2, n = 37) and B (≥30kg/m2, n = 39) and based on tube voltage in groups C (<120kV, n = 46) and D (120kV, n = 30). Coronary arteries were assessed for significant stenoses (≥50% luminal narrowing) and diagnostic accuracy was calculated. Per-patient overall sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy were 96.9%, 95.5%, 93.9%, 97.7% and 96.1%, respectively. Sensitivity and NPV were lower in groups B and D compared to groups A and C, but no statistically significant differences were observed (group A vs. B: sensitivity, 100.0% vs. 93.3%, p = 0.9493; NPV, 100% vs. 95.5%, p = 0.9812; group C vs. D: sensitivity, 100.0% vs. 92.3%, p = 0.8462; NPV, 100.0% vs. 94.1%, p = 0.8285). CCTA using 3rd-generation DSCT and (ATVS) provides high diagnostic accuracy in both non-obese and obese patients. • Coronary CTA provides high diagnostic accuracy in non-obese and obese patients. • Diagnostic accuracy between obese and non-obese patients showed no significant difference. • <120 kV studies were performed in 44 % of obese patients. • Current radiation dose-saving approaches can be applied independent of body habitus.