Added Value of Computed Tomography Virtual Intravascular Endoscopy in the Evaluation of Coronary Arteries with Stents or Plaques
Patricia Wanping Wu,
Pei-Kwei Tsay,
Zhonghua Sun,
Syu-Jyun Peng,
Chia-Yen Lee,
Ming-Yi Hsu,
Yu-Shien Ko,
I-Chang Hsieh,
Ming-Shien Wen,
Yung-Liang Wan
Affiliations
Patricia Wanping Wu
Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Pei-Kwei Tsay
Department of Public Health and Center of Biostatistics, College of Medicine, Chang Gung University, Taoyuan City 333323, Taiwan
Zhonghua Sun
Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Bentley, WA 6102, Australia
Syu-Jyun Peng
Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei City 110301, Taiwan
Chia-Yen Lee
Department of Electrical Engineering, National United University, Miaoli 360302, Taiwan
Ming-Yi Hsu
Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Yu-Shien Ko
Department of Cardiology, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
I-Chang Hsieh
Department of Cardiology, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Ming-Shien Wen
Department of Cardiology, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Yung-Liang Wan
Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Coronary computed tomography angiography (CCTA) is a widely used imaging modality for diagnosing coronary artery disease (CAD) but is limited by a high false positive rate when evaluating coronary arteries with stents and heavy calcifications. Virtual intravascular endoscopy (VIE) images generated from CCTA can be used to qualitatively assess the vascular lumen and might be helpful for overcoming this challenge. In this study, one hundred subjects with coronary stents underwent both CCTA and invasive coronary angiography (ICA). A total of 902 vessel segments were analyzed using CCTA and VIE. The vessel segments were first analyzed on CCTA alone. Then, using VIE, the segments were classified qualitatively as either negative or positive for in-stent restenosis (ISR) or CAD. These results were compared, using ICA as the reference, to determine the added diagnostic value of VIE. Of the 902 analyzed vessel segments, CCTA/VIE had sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (shown in %) of 93.9/90.2, 96.2/98.2, 96.0/97.7, 70.0/83.1, and 99.4/99.0, respectively, in diagnosing ISR or CAD, with significantly improved specificity (p = 0.025), accuracy (p = 0.046), and positive predictive value (p = 0.047). VIE can be a helpful addition to CCTA when evaluating coronary arteries.
