Correlation of Coronary Calcium Measured on Conventional Computed Tomography with Coronary Angiography Findings in Lung Transplant Patients.

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Sergio Tapia Concha, Concepción Fariñas-Álvarez, Pedro Muñoz Cacho, José Manuel Cifrian Martínez, Javier Zueco Gil, José Antonio Parra Blanco
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Abstract

Introduction and objective: The pre-transplant protocol for lung transplant candidates includes a chest CT scan to assess disease progression and often coronary angiography (CA) to rule out coronary artery disease (CAD). Coronary artery calcium is commonly observed in these pre-transplant CT scans. This study aims to evaluate the relationship between coronary calcium detected on CT and findings from CA to determine whether calcium presence could serve as an additional criterion for selecting patients for CA. Material and Methods: We included 252 consecutive lung transplant patients who had both a CT scan and CA within 365 days of each other. Coronary calcium quantification was performed using artery-based, segment artery-based, and visual assessment methods. CA findings were classified by stenosis severity: ≤20%, 21-70%, and >70%. Results: This study showed very high concordance (kappa = 0.896; 95% CI: 0.843-0.948) between the three methods, especially in distinguishing patients without and with coronary calcium (kappa = 1.000; 95% CI: 0.929-1.071). ROC analysis identified the absence of coronary calcium as the best cutoff to differentiate patients with ≤20% stenosis from those with >21%, with a sensitivity of 73.5%, specificity of 55.7%, PPV of 28.5%, and NPV of 90%. Only 11 patients (8.7%) without coronary calcium had stenosis of 21-70%, and only 2 (1.6%) had stenosis > 70%. Conclusions: The visual assessment method yielded results similar to the other two quantification methods. The absence of coronary calcium in pre-transplant CT may be a useful criterion for selecting patients for CA.

简介和目的:肺移植候选者的移植前方案包括胸部 CT 扫描,以评估疾病进展情况,通常还包括冠状动脉造影术 (CA),以排除冠状动脉疾病 (CAD)。在这些移植前 CT 扫描中通常会观察到冠状动脉钙化。本研究旨在评估 CT 检测到的冠状动脉钙化与 CA 检查结果之间的关系,以确定钙化是否可作为选择患者接受 CA 检查的额外标准。材料和方法:我们纳入了 252 例连续肺移植患者,他们在 365 天内同时进行了 CT 扫描和 CA 检查。冠状动脉钙定量采用基于动脉的方法、基于节段动脉的方法和视觉评估方法。CA 结果按狭窄严重程度分类:≤20%、21-70% 和 >70%。结果:该研究显示,三种方法的一致性非常高(kappa = 0.896;95% CI:0.843-0.948),尤其是在区分无冠状动脉钙化和有冠状动脉钙化的患者方面(kappa = 1.000;95% CI:0.929-1.071)。ROC 分析表明,无冠状动脉钙化是区分狭窄≤20% 和狭窄>21% 患者的最佳切点,敏感性为 73.5%,特异性为 55.7%,PPV 为 28.5%,NPV 为 90%。没有冠状动脉钙化的患者中只有 11 人(8.7%)的狭窄程度为 21-70%,只有 2 人(1.6%)的狭窄程度大于 70%。结论是目测评估法得出的结果与其他两种量化方法相似。移植前 CT 中无冠状动脉钙化可能是选择 CA 患者的有用标准。
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来源期刊
Tomography
Tomography Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.70
自引率
10.50%
发文量
222
期刊介绍: TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.
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