Noninvasive detection of coronary lesions by multislice computed tomography: Results of the new age pilot trial

The reliable noninvasive assessment of coronary artery disease would consti tute an important step forward in clinical cardiology. The aim of the New A ge pilot trial was to evaluate the diagnostic accuracy of multislice comput ed tomography (MSCT) in determining coronary lesions. As a gold standard fo r in vivo plaque detection, intracoronary ultrasound (ICUS) was used. Forty plaques were detected by ICUS in 15 target vessels (LAD, n = 8; RCA, n = 7 ) in patients assigned for ICUS-guided PTCA. Preinterventional MSCT was per formed in all patients and the results were compared to ICUS with regard to lesion detection and quantification. According to ICUS results, the 40 pla ques were divided into three groups: group I, mild lesions < 50% (n = 14; 4 4.36% +/- 5.77%); group II, intermediate lesions 50%-75% (n = 12; 59.18% +/ - 9.39%); and group III, severe lesions > 75% (n = 14; 91.47% +/- 3.68%). A ll MSCT scans showed sufficient image quality for analysis. Thirty of 40 (7 5%) plaques were detected by MSCT in a first blinded session. After unblind ing the ICUS results, the remaining 10 (25%) plaques could be identified. L esion severity was classified correctly in 34 of 40 (85%) plaques. Plaque c alcifications were diagnosed correctly in 16 of 19 (84.2%) plaques. Quantif ication of vessel size revealed a good correlation to the ICUS results (r(2 ) 0.68; P = 0.004), Noninvasive MSCT angiography showed good diagnostic acc uracy with regard to lesion detection and quantification of vessel sire. Th e overall good image quality, makes this new technology a promising modalit y, which might become an alternative diagnostic approach in patients with k nown or suspected coronary artery disease. (C) 2001 Wiley-Liss, Inc.