Recently developed coronary angiography with intraprocedural 320-row
computed tomography can be performed in a catheterization laboratory
(XACT) by injecting contrast medium from a place close to the coronary
arteries, thereby requiring a minimal amount of contrast medium.
However, its clinical application has not yet been established. This
study aimed to evaluate the diagnostic accuracy of XACT angiography with
a minimal volume of contrast medium in patients with suspected coronary
artery disease (CAD). A total of 167 coronary segments were analyzed in
14 patients (9 males, median age 70 years) with suspected CAD by XACT
angiography with 7.5 ml of contrast medium and invasive coronary
angiography (ICA) with standard techniques. The segmental-based
diagnostic accuracy of XACT angiography in detecting stenosis of >= 50%
and >= 75% and visualized by ICA was good (sensitivity: 74% and 62%,
specificity: 99% and 99%, positive predictive value: 93% and 80%,
and negative predictive value: 97% and 97%, respectively). These
results suggest that XACT angiography with a very low amount of contrast
medium may have strong clinical utility for screening coronary arteries
in patients with renal dysfunction or undergoing clinical procedures
such as pacemaker implantation