HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Budoff, M. J. Articles by Duerinckx, A. Search for Related Content PubMed PubMed Citation Articles by Budoff, M. J. Articles by Duerinckx, A.

STATE-OF-THE-ART PAPER

Clinical utility of computed tomography and magnetic resonance techniques for noninvasive coronary angiography

Matthew J. Budoff, MD^*,*, Stephan Achenbach, MD and Andre Duerinckx, MD

^* Division of Cardiology, Saint John's Cardiovascular Research Center, Harbor–UCLA Medical Center Research and Education Institute, Torrance, California, USA
Department of Internal Medicine II, University of Erlangen-Nuremberg, Erlangen, Germany
Division of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

Manuscript received February 25, 2003; revised manuscript received June 26, 2003, accepted July 1, 2003.

^* Reprint requests and correspondence: Dr. Matthew J. Budoff, Harbor–UCLA Research and Education Institute, 1124 W. Carson Street, RB2, Torrance, California 90502, USA.
Budoff{at}flash.net

OBJECTIVES: The purpose of this study was to provide a comprehensive review of the literature relating to electron beam angiography (EBA), magnetic resonance angiography, and spiral computed tomography, currently the three most promising noninvasive methods to visualize obstructions in the coronary tree.

BACKGROUND: Given the high costs and invasiveness of coronary angiography, there is increased interest in noninvasive coronary angiography, which has made great strides to become a clinically useful tool to augment conventional coronary angiography (CCA).

METHODS: MEDLINE searches were performed to include all articles related to noninvasive angiography utilizing either magnetic resonance imaging (MRI), multi-row detector spiral computed tomography (MDCT), and electron beam tomography (EBT). Weighted analysis was performed to define the published sensitivity and specificity for each technique.

RESULTS: Electron beam angiography (EBA) provides an overall sensitivity of 87% and specificity of 91% for the detection of obstructive coronary artery disease (CAD). Four-level MDCT data demonstrated an overall sensitivity of 59% and specificity of 89%, with higher accuracy in two recent studies of 16-level detector devices. Magnetic resonance angiography demonstrated sensitivity for detection of obstructive CAD of 77% and specificity of 71%.

CONCLUSIONS: Noninvasive coronary angiography is a rapidly developing technique and currently not an alternative to CCA in all cases. All three methods are currently used clinically in certain centers with appropriate expertise. Selective use should prove both cost-effective and provide a safer, less-invasive method for patients to determine the need for medical versus revascularization therapy.

Abbreviations and Acronyms   3D = three-dimensional   CABG = coronary artery bypass graft   CAC = coronary artery calcifications   CAD = coronary artery disease   CCA = conventional coronary angiography   CT = computed tomography   EBA = electron-beam angiography   EBT = electron-beam tomography   ECG = electrocardiographic   HR = heart rate   MDCT = multi-row-detector spiral computed tomography   MRA = magnetic resonance angiography   MRI = magnetic resonance imaging

This article has been cited by other articles:

				M. P. Ostrom, A. Gopal, N. Ahmadi, K. Nasir, E. Yang, I. Kakadiaris, F. Flores, S. S. Mao, and M. J. Budoff Mortality Incidence and the Severity of Coronary Atherosclerosis Assessed by Computed Tomography Angiography J. Am. Coll. Cardiol., October 14, 2008; 52(16): 1335 - 1343. [Abstract] [Full Text] [PDF]

				J. D Schuijf and J. J Bax CT angiography: an alternative to nuclear perfusion imaging? Heart, March 1, 2008; 94(3): 255 - 257. [Full Text] [PDF]

				A. J. Duerinckx Can the Targeted Use of MR Angiography After CT Angiography Help Assess the Severity of Focal Calcific Coronary Lesions? Am. J. Roentgenol., December 1, 2007; 189(6): 1333 - 1334. [Full Text] [PDF]

				M. Mahesh and D. D. Cody AAPM/RSNA Physics Tutorial for Residents: Physics of Cardiac Imaging with Multiple-Row Detector CT RadioGraphics, September 1, 2007; 27(5): 1495 - 1509. [Abstract] [Full Text] [PDF]

				J. J. Bax, S. E. Inzucchi, R. O. Bonow, J. D. Schuijf, M. R. Freeman, E. J. Barrett, and on behalf of the Global Dialogue Group for the Eva Cardiac Imaging for Risk Stratification in Diabetes Diabetes Care, May 1, 2007; 30(5): 1295 - 1304. [Full Text] [PDF]

				M. J. Budoff, S. Achenbach, R. S. Blumenthal, J. J. Carr, J. G. Goldin, P. Greenland, A. D. Guerci, J. A.C. Lima, D. J. Rader, G. D. Rubin, et al. Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology Circulation, October 17, 2006; 114(16): 1761 - 1791. [Full Text] [PDF]

				Detection of coronary complications after the arterial switch operation for transposition of the great arteries: first experience with multislice computed tomography in children. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 639 - 643.

				A Vacca, P Siotto, A Cauli, R Montisci, P Garau, V Ibba, A Mameli, G Passiu, S Iliceto, and A Mathieu Absence of epicardial coronary stenosis in patients with systemic sclerosis with severe impairment of coronary flow reserve Ann Rheum Dis, February 1, 2006; 65(2): 274 - 275. [Full Text] [PDF]

				D. S. Berman, R. Hachamovitch, L. J. Shaw, J. D. Friedman, S. W. Hayes, L. E.J. Thomson, D. S. Fieno, G. Germano, P. Slomka, N. D. Wong, et al. Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med., January 1, 2006; 47(1): 74 - 82. [Abstract] [Full Text] [PDF]

				S. Tridandapani, J. B. Fowlkes, and J. M. Rubin Echocardiography-Based Selection of Quiescent Heart Phases: Implications for Cardiac Imaging J. Ultrasound Med., November 1, 2005; 24(11): 1519 - 1526. [Abstract] [Full Text] [PDF]

				V. Fuster, Z. A. Fayad, P. R. Moreno, M. Poon, R. Corti, and J. J. Badimon Atherothrombosis and High-Risk Plaque: Part II: Approaches by Noninvasive Computed Tomographic/Magnetic Resonance Imaging J. Am. Coll. Cardiol., October 4, 2005; 46(7): 1209 - 1218. [Abstract] [Full Text] [PDF]

				W. Hollingworth Radiology Cost and Outcomes Studies: Standard Practice and Emerging Methods Am. J. Roentgenol., October 1, 2005; 185(4): 833 - 839. [Full Text] [PDF]

				H. Sakuma, Y. Ichikawa, N. Suzawa, T. Hirano, K. Makino, N. Koyama, M. Van Cauteren, and K. Takeda Assessment of Coronary Arteries with Total Study Time of Less than 30 Minutes by Using Whole-Heart Coronary MR Angiography Radiology, October 1, 2005; 237(1): 316 - 321. [Abstract] [Full Text] [PDF]

				J D Schuijf, L J Shaw, W Wijns, H J Lamb, D Poldermans, A de Roos, E E van der Wall, and J J Bax Cardiac imaging in coronary artery disease: differing modalities Heart, August 1, 2005; 91(8): 1110 - 1117. [Full Text] [PDF]

				E. K. Fishman Multidetector-row computed tomography to detect coronary artery disease: the importance of heart rate Eur. Heart J. Suppl., August 1, 2005; 7(suppl_G): G4 - G12. [Abstract] [Full Text] [PDF]

				M. J. Budoff, M. C. Cohen, M. J. Garcia, J. McB. Hodgson, W. G. Hundley, J. A.C. Lima, W. J. Manning, G. M. Pohost, P. M. Raggi, G. P. Rodgers, et al. ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training J. Am. Coll. Cardiol., July 19, 2005; 46(2): 383 - 402. [Full Text] [PDF]

				J. Kefer, E. Coche, G. Legros, A. Pasquet, C. Grandin, B. E. Van Beers, J.-L. Vanoverschelde, and B. L. Gerber Head-to-Head Comparison of Three-Dimensional Navigator-Gated Magnetic Resonance Imaging and 16-Slice Computed Tomography to Detect Coronary Artery Stenosis in Patients J. Am. Coll. Cardiol., July 5, 2005; 46(1): 92 - 100. [Abstract] [Full Text] [PDF]

				A Kuettner, T Beck, T Drosch, K Kettering, M Heuschmid, C Burgstahler, C D Claussen, A F Kopp, and S Schroeder Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution Heart, July 1, 2005; 91(7): 938 - 941. [Abstract] [Full Text] [PDF]

				S. K Prasad, R. G Assomull, and D. J Pennell Recent developments in non-invasive cardiology BMJ, December 11, 2004; 329(7479): 1386 - 1389. [Full Text] [PDF]

				E. Martuscelli, A. Romagnoli, A. D'Eliseo, M. Tomassini, C. Razzini, M. Sperandio, G. Simonetti, F. Romeo, and J.L. Mehta Evaluation of Venous and Arterial Conduit Patency by 16-Slice Spiral Computed Tomography Circulation, November 16, 2004; 110(20): 3234 - 3238. [Abstract] [Full Text] [PDF]

				P. G. Danias, A. Roussakis, and J. P.A. Ioannidis Diagnostic performance of coronary magnetic resonance angiography as compared against conventional x-ray angiography: A meta-analysis J. Am. Coll. Cardiol., November 2, 2004; 44(9): 1867 - 1876. [Abstract] [Full Text] [PDF]

				W. W. O'Neill and S. R. Dixon The year in interventional cardiology J. Am. Coll. Cardiol., March 3, 2004; 43(5): 875 - 890. [Full Text] [PDF]