Browsing by Author "Knaapen, Paul"
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Publication Diagnostic performance of CCTA and CTP imaging for clinically suspected in-stent restenosis: A meta-analysis(2024) Dahdal, Jorge; Jukema, Ruurt A.; Remmelzwaal, Sharon; Raijmakers, Pieter G.; Harst, Pim van der; Guglielmo, Marco; Cramer, Maarten J.; Chamuleau, Steven A.J.; Diemen, Pepijn A. van; Knaapen, Paul; Danad, IbrahimAims: The objective of this study is to conduct a meta-analysis to assess the diagnostic performance of Coronary Computed Tomography Angiography (CCTA) and a hybrid approach that incorporates Computed Tomography Perfusion (CTP) in addition to CCTA (CCTA þ CTP) for the detection of in-stent restenosis (ISR), as defined by angiography. Methods: A comprehensive search of articles identified 18,513 studies. After removing duplicates, title/abstract screening, and full-text review, 17 CCTA and 3 CCTA þ CTP studies were included. Only studies using 64-slices multidetector computed tomography (CT) were considered eligible. Results: The per-patient ISR prevalence was 43 %, with 92 % of stents fully interpretable with CCTA. Meta-analysis exhibited a per-stent CCTA (n ¼ 2674) sensitivity of 90 % (95 % CI; 84–94 %), specificity of 89 % (95 % CI; 86–92 %), positive likelihood ratio of 7.17 (95 % CI; 5.24–9.61), negative likelihood ratio of 0.17 (95 % CI; 0.10–0.25), and diagnostic odds ratio of 45.7 (95 % CI; 22.71–82.43). Additional sensitivity analyses revealed no influence of stent diameter or strut thickness on the diagnostic yield of CCTA. The per-stent diagnostic performance of CCTA þ CTP (n ¼ 752) did not show differences compared to CCTA. Conclusions: With currently utilized scanners, CCTA and CCTA þ CTP demonstrated high diagnostic performance for in-stent restenosis evaluation. Consequently, a history of previous stent implantation should not be an argument to preclude using these methods in clinically suspected patients.