Diagnostic value of 64-slice CT angiography in coronary artery disease: A systematic review

PurposeTo perform a systematic review of the diagnostic value of 64-multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography.Materials and methodsA search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 64-slice MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analysed at segment-, vessel- and patient-based assessment.ResultsFifteen studies met selection criteria and were included for analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value as well as 95% confidence interval (CI) were 97% (94 and 99%), 88% (79 and 97%), 94% (91 and 97%), and 95% (90 and 99%) for patient-based assessment; 92% (85 and 99%), 92% (85 and 99%), 78% (66 and 91%) and 98% (96 and 99%) for vessel-based assessment; 90% (85 and 94%), 96% (95 and 97%), 75%(68 and 82%) and 98% (98 and 99%) for segment-based assessment, respectively. No significant difference was found in the diagnostic accuracy of 64-slice CT in the detection of CAD when comparison was performed either among four main coronary arteries, or between proximal and middle or distal segments (p > 0.05).ConclusionOur results showed that 64-slice CT angiography has a high-diagnostic value in the detection of CAD. Severe coronary artery calcification seems to be the major factor affecting the visualisation and assessment.