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Dual-energy CT angiography in peripheral arterial occlusive disease-accuracy of maximum intensity projections in clinical routine and subgroup analysis.

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Title: Dual-energy CT angiography in peripheral arterial occlusive disease-accuracy of maximum intensity projections in clinical routine and subgroup analysis.
Authors: Kau T (AUTHOR), Eicher W (AUTHOR), Reiterer C (AUTHOR), Niedermayer M (AUTHOR), Rabitsch E (AUTHOR), Senft B (AUTHOR), Hausegger KA (AUTHOR), Kau, Thomas1 (AUTHOR), Eicher, Wolfgang (AUTHOR), Reiterer, Christian (AUTHOR), Niedermayer, Martin (AUTHOR), Rabitsch, Egon (AUTHOR), Senft, Birgit (AUTHOR), Hausegger, Klaus A (AUTHOR)
Source: European Radiology. Aug2011, Vol. 21 Issue 8, p1677-1686. 10p.
Subjects: Leg radiography, Angiography, Arterial occlusions, Computed tomography, Diagnostic imaging, Digital subtraction angiography, Leg, Computers in medicine, Nonparametric statistics, Peripheral vascular diseases
Abstract: Objective: To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD).Methods: In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard.Results: In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions (κ = 0.72; κ = 0.66), moderate in the crural region (κ = 0.55), slight in pedal arteries (κ = 0.10) and very good in bypass segments (κ = 0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia.Conclusion: While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. [ABSTRACT FROM AUTHOR]
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Abstract:<bold>Objective: </bold>To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD).<bold>Methods: </bold>In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard.<bold>Results: </bold>In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions (κ = 0.72; κ = 0.66), moderate in the crural region (κ = 0.55), slight in pedal arteries (κ = 0.10) and very good in bypass segments (κ = 0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia.<bold>Conclusion: </bold>While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. [ABSTRACT FROM AUTHOR]
ISSN:09387994
DOI:10.1007/s00330-011-2099-1