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Feasibility of an automatic computer-assisted algorithm for the detection of significant coronary artery disease in patients presenting with acute chest pain.

Authors
 Ki-Woon Kang  ;  Hyuk-Jae Chang  ;  Hackjoon Shim  ;  Young-Jin Kim  ;  Byoung-Wook Choi  ;  Woo-In Yang  ;  Jee-Young Shim  ;  Jongwon Ha  ;  Namsik Chung 
Citation
 European Journal of Radiology, Vol.81(4) : 640-646, 2012 
Journal Title
 European Journal of Radiology 
ISSN
 0720-048X 
Issue Date
2012
Abstract
Automatic computer-assisted detection (auto-CAD) of significant coronary artery disease (CAD) in coronary computed tomography angiography (cCTA) has been shown to have relatively high accuracy. However, to date, scarce data are available regarding the performance of auto-CAD in the setting of acute chest pain. This study sought to demonstrate the feasibility of an auto-CAD algorithm for cCTA in patients presenting with acute chest pain. We retrospectively investigated 398 consecutive patients (229 male, mean age 50±21 years) who had acute chest pain and underwent cCTA between Apr 2007 and Jan 2011 in the emergency department (ED). All cCTA data were analyzed using an auto-CAD algorithm for the detection of >50% CAD on cCTA. The accuracy of auto-CAD was compared with the formal radiology report. In 380 of 398 patients (18 were excluded due to failure of data processing), per-patient analysis of auto-CAD revealed the following: sensitivity 94%, specificity 63%, positive predictive value (PPV) 76%, and negative predictive value (NPV) 89%. After the exclusion of 37 cases that were interpreted as invalid by the auto-CAD algorithm, the NPV was further increased up to 97%, considering the false-negative cases in the formal radiology report, and was confirmed by subsequent invasive angiogram during the index visit. We successfully demonstrated the high accuracy of an auto-CAD algorithm, compared with the formal radiology report, for the detection of >50% CAD on cCTA in the setting of acute chest pain. The auto-CAD algorithm can be used to facilitate the decision-making process in the ED.
Full Text
http://www.sciencedirect.com/science/article/pii/S0720048X12000332
DOI
10.1016/j.ejrad.2012.01.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
심학준(Shim, Hack Joon)
양우인(Yang, Woo In)
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90236
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