Fact Sheet :Technological Difference Between EBCT And Multislice CT   The insurmountable speed barrier to mechanical CT scanners

Electron Beam  CT	Multi-slice CT or Spiral CT
Weightless electron beam source	Uses heavy mechanical Xray source
More than 1000 published studies	Limited  published studies
Widely  used  for cardiac scanning	Widely used for non-cardiac scanning
FDA approved for cardiac scanning	Not FDA approved cardiac scanning
No post processing of images                      Not operator dependent                                     Standardized protocol      Consistent results across different laboratories	Post processing of images needed               Subjective and operator dependent                     Protocols under development                     Limited experience
No post processing of images                      Not operator dependent	Post processing of images needed               Subjective and operator dependent
Better temporal resolution                        Actual scan speed up to 50 ms/slice	Better spatial resolution                                 Actual scan speed up to 330-500 ms/slice; virtual scan speed of 250ms/slice achieved by acquiring data from half slice and extrapolating data
No motion artifact; reproducible                     5-10 % interscan variability in calcium score	More motion artifacts; poor reproducibility      35 % interscan variability in calcium score 6
5% false negative	30%  false negative
Low radiation Prospective triggering; radiation is applied only 10% of cardiac cycle, no discarding of acquired data      EBCT Coronary calcium scan radiation dose : 0.7- 1.0 mSv Electron Beam angiogram radiation dose: Morin3: 1.1 mSv3;   Hunold4: 1.5-2.0mSv Safer for women; Lower breast tissue radiation dose : Only 20% of entry  dose	5-10 times higher radiation 1,2             Retrospective triggering (Radiation is applied continuously; partial data acquisition on each scan;  90% of acquired data is subsequently  discarded);                                                        MSCT Coronary calcium scan radiation dose: 5.2-6.4  mSv MSCT angiogram radiation dose:    Morin3: 9.3-11.3mSv;  Hunold4: 8.1-13mSv Effective radiation dose  another 25% higher in women5;  Breast tissue receives highest radiation dose
Calcium scores correlated with histopathology and IVUS studies	No autopsy or IVUS corretation data for calcium scores obtained with MSCT
95% success rate for CTangiography	30% success rate for CT angiography

Comparison of Coronary Artery Calcium Scan Results  

	EBCT	Mechanical (Multi-slice CT / Spiral CT)
Sensitivity	High  ( 98%)	Low for moderate-low score (ave. 74%)
Specificity	High  ( 99 %)	Low for moderate-low score (ave. 70%)
Reproducibility	High	Moderate-low (variation average >100 points)
Negative Predictive Value	Very high	Moderate

 Comparison of Contrast-enhanced CT Angiogram Results

	EBCT	Mechanical (Multi-Slice CT / Spiral CT)
Sensitivity	High  ( 86-95 %)	Low for moderate-low score (ave. 68 %)
Specificity	High  ( 91-95 % )	Low for moderate-low score (ave. 83%)
Standardized protocol	Yes	Under development
Published clinical papers	> 50	< 8
FDA approved	Yes	No
Success rate in visualizing all three major epicardial arteries	95%. HR can range up to 130/min	30%. Beta blocker required  to slow heart rate to <60/min

  Correlation between EBA and Coronary Angiograhy 

Author, Year	No of Patients	Sensitivity (%)	Specificity (%)
Moshage,Radiology 95	20	74	100
Nakanishi, 1997	37	74	94
Reddy, Radiology 1998	23	88	79
Rensing,Circulation 98	37	77	94
Achenbach,NEJM 1998	125	92	94
Schmermund,JACC 98	28	83	91
Budoff, AJC 1999	52	87	91
Moshage, 2000	118	90	82
Achenbach,Heart  2000	36	92	91
Ropers, Z Kardiol 2000	118	90	82
Lu , Invest Rad 2002	107	91	94
AVERAGE	701	87 %	91 %

  

Correlation between MSCT Angiography and Coronary Angiograhy 

Author, Year	No of patients	Sensitivity (%)	Specificity (%)
Knez, 2000	44