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.

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James Udelson, MD, from Tufts and an investiogator in the PRECISE trial, explains how FFR-CT combined with coronary CT outperformed the standard of care in patients with stable chest pain, or low-risk patients with suspected coronary involvement.

James Udelson, MD, an investigator involved with the PRECISE trial, explained how patient outcomes were improved by 70% from the current standard of care.

A spectral CT image of the heart showing ischemia in the myocardium by mapping the iodine density in the tissues as a surrogate for bloodflow. Example is from Philips Healthcare, displayed at the 2022 ACC meeting. Example of cardiac perfusion imaging. #SCCT

Suhny Abbara, MD, editor of Radiology: Cardiothoracic Imaging and chief of cardiothoracic imaging for University of Texas Southwestern Medical Center, discusses how spectral computed tomography (CT) can help both cardiac and general CT imaging.

The new study, presented at the AHA Scientific Sessions 2022 conference in Chicago, focused on data from more than 2,000 patients. 

Ed Nicol, MD, MBA, FSCCT, consultant cardiologist, honorary senior clinical lecturer, Kings College London, and president-elect of the Society of Cardiovascular Computed Tomography (SCCT), discusses what he sees as the big technology advances in cardiac CT. #SCCT #SCCT22 #RSNA22

Ed Nicol, MD, MBA, president-elect of the Society of Cardiovascular Computed Tomography, discusses what he sees as the big technology advances in cardiac CT.

Leslee Shaw, PhD, MSCCT, FACC, MASNC, FAHA, director of the Blavatnik Family Women's Health Research Institute, a professor of medicine at the Icahn School of Medicine at Mount Sinai, and a former president of both SCCT and ASNC. She explains the sex differences in cardiovascular imaging presentations in women versus men.

Leslee Shaw, PhD, director of the Blavatnik Family Women's Health Research Institute, a professor of medicine at the Icahn School of Medicine at Mount Sinai, and a former president of both SCCT and ASNC, explains the sex differences in cardiovascular imaging presentations in women versus men. 

Ricardo Cury, MD, MBA, MSCCT, chairman of radiology, direct of cardiac imaging, Baptist Health South Florida  and Miami Cardiac and Vascular Institute, discusses the new CAD-RADS 2.0 cardiac imaging reporting criteria at the 2022 SCCT meeting. Interview with Radiology Business Editor Dave Fornell.

Ricardo Cury, MD, chairman of radiology and director of cardiac imaging, Baptist Health South Florida and Miami Cardiac and Vascular Institute, discusses the new CAD-RADS 2.0 cardiac imaging reporting criteria.

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.

Ed Nicol, MD, president-elect of the Society of Cardiovascular Computed Tomography, provided us with an exclusive look at how AI is expected to change cardiac imaging.

Left, HeartFlow's RoadMap analysis enables cardiac CT readers to identify stenoses in the major coronary arteries. The AI provides visualization and quantification of the location and severity of anatomic narrowings. Right image, HeartFlow's Plaque Analysis AI algorithm automates assessment of coronary plaque characteristics and volume on CCTA exams to greatly reduce the time it takes to manually assess and quantify these features.

The solutions, Plaque Analysis and RoadMap Analysis, both use coronary CT angiography to provide clinicians with a noninvasive look at patients who present with coronary artery disease and face a heightened myocardial infarction risk.

Coronary CT Angiography (CCTA) has evolved into a much more helpful resource than interventional cardiologists may have originally believed. In fact, the Society of Cardiovascular Computed Tomography (SCCT) emphasized in a new expert consensus statement that CCTA provides specialists with an effective tool in the preparation and optimization of coronary procedures. The 2021 chest pain guidelines elevated CTA to a class 1A recommendation. Harold Litt , MD, explains the use of CCTA in the ED.

Harold Litt, MD, explains the use of cardiac CT as a primary imaging exam for chest pain at his emergency department over the past decade.

CT has been used for planning and procedural guidance in pulmonary vein isolation (PVI) for about 20 years. It shows the anatomy to the electrophysiologist. The EPs also can load the imaging into their EP mapping system. It also shows them the location of the esophagus and the phrenic nerve so they can avoid these during the procedures. #PVI #EPeeps

Harold Litt, MD, division chief of cardiothoracic imaging and director of the Center for Advanced CT Imaging Sciences at the Perelman School of Medicine of the University of Pennsylvania, explains the role of cardiac CT in EP procedures.

The Society of Cardiovascular Computed Tomography developed and published the new document to help educate healthcare providers who regularly treat acute chest pain in the emergency department. 

Around the web

“This type of screening could be used to identify individuals who would benefit from statin medication but are currently untreated," one specialist said. The full analysis will be presented at RSNA 2022 in Chicago. 

U.S. physicians might be missing out on innovative medical research due to the overwhelming amount of reading and clinical work they are faced with, according to a recent survey.

Physicians are now bracing for payment cuts after the Centers for Medicare and Medicaid Services (CMS) published its final rule for the 2023 Physician Fee Schedule.

   
   
   
   
   
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