alexa Coronary angiography with flat panel digital detectors significantly increases the sensitivity for calcium detection in relation to conventional fluoroscopy: comparison of both systems with intravascular ultrasound.


Journal of Clinical & Experimental Cardiology

Author(s): de la Torre Hernandez JM, Laso FS, Ruisanchez C, Zueco J, Figueroa A,

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Abstract OBJECTIVE: To compare the sensitivity and specificity for coronary calcium detection of two fluoroscopic systems: 1) conventional system based on image intensifier chains (CONV); and 2) flat panel digital detector (FPDD) system, using intravascular ultrasound (IVUS) as the gold standard. BACKGROUND: Coronary calcification represents advanced atherosclerotic disease and has implications during coronary interventions. Angiography has been reported to have low sensitivity for calcium detection compared with IVUS. METHODS: Lesion calcification was assessed by two different fluoroscopic systems (FPDD and CONV), and by IVUS. RESULTS: In two consecutive periods, a total of 200 consecutive patients were included, 100 in each group. Clinical characteristics were similar, without significant differences between groups. In the CONV group, IVUS detected calcium in 77\% of cases, and angiography in 32\%. Sensitivity was 41.6\% and specificity 91.3\%. In the FPDD group, IVUS reported calcification in 79\% of patients, and angiography in 57\%. Sensitivity was 72\% (p < 0.0001 for comparison with CONV) and specificity was 90.4\%. CONCLUSION: The new fluoroscopic systems, based on FPDD, considerably increase the sensitivity for calcium detection without detrimental effect on specificity.
This article was published in J Invasive Cardiol and referenced in Journal of Clinical & Experimental Cardiology

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