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Pilot study of the multicentre DISCHARGE Trial: image quality and protocol adherence results of computed tomography and invasive coronary angiography

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  • Gianluca De Rubeis
  • Adriane E Napp
  • Peter Schlattmann
  • Jacob Geleijns
  • Michael Laule
  • Henryk Dreger
  • Klaus Kofoed
  • Mathias Sørgaard
  • Thomas Engstrøm
  • Hans Henrik Tilsted
  • Alberto Boi
  • Michele Porcu
  • Stefano Cossa
  • José F Rodríguez-Palomares
  • Filipa Xavier Valente
  • Albert Roque
  • Gudrun Feuchtner
  • Fabian Plank
  • Cyril Štěchovský
  • Theodor Adla
  • Stephen Schroeder
  • Thomas Zelesny
  • Matthias Gutberlet
  • Michael Woinke
  • Mihály Károlyi
  • Júlia Karády
  • Patrick Donnelly
  • Peter Ball
  • Jonathan Dodd
  • Mark Hensey
  • Massimo Mancone
  • Andrea Ceccacci
  • Marina Berzina
  • Ligita Zvaigzne
  • Gintare Sakalyte
  • Algidas Basevičius
  • Małgorzata Ilnicka-Suckiel
  • Donata Kuśmierz
  • Rita Faria
  • Vasco Gama-Ribeiro
  • Imre Benedek
  • Teodora Benedek
  • Filip Adjić
  • Milenko Čanković
  • Colin Berry
  • Christian Delles
  • Erica Thwaite
  • Gershan Davis
  • Juhani Knuuti
  • Mikko Pietilä
  • DISCHARGE Trial Group
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OBJECTIVE: To implement detailed EU cardiac computed tomography angiography (CCTA) quality criteria in the multicentre DISCHARGE trial (FP72007-2013, EC-GA 603266), we reviewed image quality and adherence to CCTA protocol and to the recommendations of invasive coronary angiography (ICA) in a pilot study.

MATERIALS AND METHODS: From every clinical centre, imaging datasets of three patients per arm were assessed for adherence to the inclusion/exclusion criteria of the pilot study, predefined standards for the CCTA protocol and ICA recommendations, image quality and non-diagnostic (NDX) rate. These parameters were compared via multinomial regression and ANOVA. If a site did not reach the minimum quality level, additional datasets had to be sent before entering into the final accepted database (FADB).

RESULTS: We analysed 226 cases (150 CCTA/76 ICA). The inclusion/exclusion criteria were not met by 6 of the 226 (2.7%) datasets. The predefined standard was not met by 13 of 76 ICA datasets (17.1%). This percentage decreased between the initial CCTA database and the FADB (multinomial regression, 53 of 70 vs 17 of 75 [76%] vs [23%]). The signal-to-noise ratio and contrast-to-noise ratio of the FADB did not improve significantly (ANOVA, p = 0.20; p = 0.09). The CTA NDX rate was reduced, but not significantly (initial CCTA database 15 of 70 [21.4%]) and FADB 9 of 75 [12%]; p = 0.13).

CONCLUSION: We were able to increase conformity to the inclusion/exclusion criteria and CCTA protocol, improve image quality and decrease the CCTA NDX rate by implementing EU CCTA quality criteria and ICA recommendations.

KEY POINTS: • Failure to meet protocol adherence in cardiac CTA was high in the pilot study (77.6%). • Image quality varies between sites and can be improved by feedback given by the core lab. • Conformance with new EU cardiac CT quality criteria might render cardiac CTA findings more consistent and comparable.

Original languageEnglish
JournalEuropean Radiology
Volume30
Issue number4
Pages (from-to)1997-2009
Number of pages13
ISSN0938-7994
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • Angiography, coronary, Coronary artery disease, CT angiography, Medical imaging, Trial protocols

ID: 59126178