Computed Tomography

Cardiac computed tomography (CT) has become a primary cardiovascular imaging modality in the past 20 years, and was recommended as a 1A recommendation in the 2021 chest pain assessment guidelines. CT calcium scoring has became a primary risk assessment for coronary artery disease and whether patients should be on statins. Coronary CT angiography (CCTA) is used to for anatomical assessment of the arteries for plaque burden and to identify areas of blockage that may cause ischemia and heart attacks. Additional use of contrast CT perfusion or fractional flow reserve CT (FFR-CT) can offer physiological information on the function of the heart. CT plays a primary role in structural heart assessments for heart valves, repair of congenital defects and left atrial appendage occlusion (LAAO) for both pre-procedure planning and procedural guidance. Find more news on general radiology CT use.

Illustration of a left atrial appendage occlusion (LAAO) procedure using a Watchman device. Image courtesy of Johns Hopkins Medicine. #LAA #LAAO

There is not agreement among the top structural heart experts if CT is required for left atrial appendage occlusion (LAAO), but a Henry Ford Hospital study shows it can improve outcomes.

Fat attenuation index (FAI) CT imaging of coronary artery fat can show inflammation and can help pin-point vulnerable plaques, or show the reversal of inflammation due to drug therapies. The technology is being developed by the vendor Caristo, which has European CE mark and the company is seeking FDA clearance. #SCCT #SCCT2022

Ron Blankstein, MD, Brigham and Women's Hospital, explains recent advances in coronary computed tomography angiography (CCTA) technology. 

A cardiac CT scan being performed at Duly Healthcare in suburban Chicago in the spring of 2022. This is one of the first outpatient cardiology clinics in the U.S. to implement a CCTA program for screening non-acute chest pain patients and for structural heart evaluations. This applies to CCTA, CTA, Cardiac CT, and CT angiography and coronary CT angiography.

With the elevation of cardiac CT to a 1A indication in the 2021 Chest Pain Guidelines, there has been a large amount of interest in starting coronary artery CT angiography (CCTA) programs. 

Society of Cardiovascular Computed Tomography (SCCT) President Brian Ghoshhajra, MD, detailed three challenges he is making to SCCT members in the coming year. 

How to get paid, reimbursed, for cardiac CT, CTA CCTA. #SCCT #SCCT2022

Ahmad M. Slim, MD, associate professor of medicine with the University of Washington and regional chief medical officer with the Pulse Heart Institute, explained how imagers get paid for coronary computed tomography angiography (CCTA) exams.

Ron Blankstein, MD, MSCCT, associate director, cardiovascular imaging program, director, cardiac computed tomography, Brigham and Women's Hospital, and professor of medicine, Harvard Medical School, was a co-author on the ACC 2021 Chest Pain Guidelines,[1] which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for front line imaging. He gave an overview of the guidelines during the 2022 Society of Cardiovascular CT (SCCT) meeting in July.  #SCCT2022

Ron Blankstein, MD, associate director of the cardiovascular imaging program and director of the cardiac computed tomography program for Brigham and Women's Hospital, was a co-author on the ACC 2021 Chest Pain Guidelines, which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for frontline imaging. 

Mitral annular calcium (MAC) does not appear to have a negative effect on long-term transcatheter aortic valve replacement (TAVR) outcomes, according to new research published in the American Journal of Cardiology.

Researchers from Cleveland Clinic reviewed data from more than 400 patients, presenting their findings in the American Journal of Cardiology.

CT coronary artery calcium (CAC) scoring, also known as the Agatston score, to assess the risk a patient has for future heart attacks and help decide if a patient requires statins.

Mike Shapiro, DO, MD, director of the Center for Prevention of Cardiovascular Disease at Wake Forest University, discusses the current guidelines for computed tomography (CT) calcium scoring as a screening test to assess heart attack risk.

AI cardiology vendor Cleerly offers an FDA-cleared coronary artery soft plaque assessment.

The company has now raised $248M in total to help develop, commercialize and market its FDA-cleared technology. 

Examples of new cardiac CT technologies at the 2022 SCCT meeting. Top left clockwise, realistic 3D rendering inside the heart, the GE Revolution Apex scanner, Cleerly's AI automated soft plaque assessment, and CT strain imaging from Medis. #SCCT #SCCT2022 #YesCCT #CTA #CCTA, new computed tomography technology

View a variety of images from the 2022 Society of Cardiovascular Computed Tomography (SCCT) meeting in Las Vegas.

Example of a patient's coronary tree extracted from a cardiac CT scan. CT allows very detailed anatomical imaging and now physiological and plaque information that can be useful in pre-planning interventional procedures. Imaging from the GE Revolution Apex system at SCCT 2022.

Jonathon Leipsic, MD, chairman of the Department of Radiology, University of British Columbia, explains how noninvasive computed tomography angiography (CTA) can be used to aid in planning interventional cardiology procedures for percutaneous coronary intervention (PCI) and chronic total occlusions (CTO). 

AI-generated coronary tree from a patient's CT scan showing a color code of areas of interest for plaque burden from the Cleerly software shown at SCCT 2022.

Former European Society of Cardiology president Prof. Jeroen Bax explains the difficulty in quantifying these plaques manually and how artificial intelligence may change this to allow rapid, detailed quantitative analysis. 

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