Radiologists: Take the deep dive into advanced cardiovascular CT at SCCT

"There has been so much advancement in the field of cardiovascular CT in the last decade, and SCCT has been at the forefront of this," Coords notes during an interview with Cardiovascular Business.

Coords credits SCCT with helping shape many of the major milestones in cardiac CT, from securing a Category I CPT reimbursement code for CCTA in 2010, to supporting the clinical evidence that led to CCTA receiving a Class I recommendation in chest pain guidelines in 2021.

Unlike many imaging conferences, SCCT brings together both radiologists and cardiologists involved in cardiovascular CT. Coords says this reflects the evolution of cardiac CT over the past decade.

"Coronary CTA came up as a sort of dual role,” he says. “You have cardiologists who were starting to interpret them as well as radiologists, and now the roads have converged.”

Today, some healthcare systems rely primarily on radiologists to interpret CCTA studies, while others use cardiologists, or collaborative models. That makes the exchange of ideas particularly valuable.

For Coords, one of the greatest benefits of attending SCCT is learning how different institutions are implementing cardiovascular CT programs and addressing operational challenges.

"It's been an incredible opportunity every year that I've attended to see how people are doing things within their own healthcare systems, talk through new technology, review emerging data, and meet the authors presenting new research," he says.

Rapid growth of CCTA expected to continue

The demand for cardiovascular CT shows no signs of slowing. Coords describes conversations with colleagues across the country who are experiencing surging examination volumes and increasing demand for qualified physicians.

"Volumes have really gone parabolic," he says. "Everyone was hiring."

He believes additional clinical evidence supporting early detection of coronary artery disease will further accelerate adoption. Looking ahead, Coords sees a future where CCTA could eventually be used as a screening tool for asymptomatic patients, representing what he views as the next major milestone in the modality's evolution.

"I would say we've had two major milestones so far," he says. "The first was the Category I code in 2010. The second was the Class I recommendation for chest pain in 2021. The third big one that will eventually happen sometime in my career will be true screening indications for asymptomatic individuals.

If that occurs, he notes, cardiovascular CT could shift from primarily diagnosing existing disease to identifying coronary atherosclerosis before symptoms develop. A lot of cardiology risk assessments today are based on population health statistics, but he says we have the technology to look under the hood or each patient to offer a very individualized risk assessment. This will have a profound impact on preventive cardiology with the ability to screen, catch very early disease and treat patients years before that would otherwise become symptomatic.

"At some point, it may become common sense to simply take a look," Coords says. "Once that happens, the growth we're seeing now will seem very small in comparison because we'll be able to catch disease before events happen and potentially save more lives."

Beyond clinical education to cover the business side of CCTA

While conferences such as the Radiological Society of North America (RSNA) offer extensive imaging education, Coords believes SCCT fills a different niche by focusing heavily on the practical realities of building and sustaining cardiovascular CT programs.

"The clinical side is very important, but if you don't understand the business aspect of it, oftentimes programs won't be successful," Coords explains.

That includes discussions around reimbursement, workflow design, staffing, scanner selection, post-processing software, and artificial intelligence applications such as fractional flow reserve CT (FFR-CT) and plaque analysis.

As cardiovascular CT volumes increase, many hospitals and imaging centers are transitioning away from shared CT scanners toward dedicated cardiac CT systems. Determining which scanner technology best fits a particular practice remains a critical decision.

"People need dedicated CT scanners, but what CT scanner do you need for your individual practice?" Coords says. "There is a lot to consider based on your patient population and healthcare network."

The ability to discuss those questions directly with peers who have already navigated similar challenges is one of the meeting's most valuable features, he adds. These scanners also are often used for more than just coronary diagnostic imaging if a hospital has a structural heart program that require long run-off scans and specific measurement software, and interventional cardiology at some centers are now routinely using CCTA scans to preplan procedures and need detailed imaging inside vessels.

As a smaller meeting SCCT offers larger access

Although SCCT's exhibit floor is considerably smaller than those found at larger conferences, Coords sees this as a significant advantage. Simply, it offers more time with vendors to take a deeper dive in demos and discussions.

"You can have those industry partners available to talk one-on-one," he says. "If you're looking to build a structural heart program, you can go from one vendor to another and talk about how their technology applies to what you're trying to accomplish at your institution."

The meeting attracts major CT scanner manufacturers, advanced visualization companies, and software developers focused on cardiovascular imaging, structural heart planning, plaque analysis, and AI-enabled workflows.

The conference's smaller scale also allows attendees the ability to meet many of the top CCTA experts in the world than they would at larger national meetings.

Preparing the next generation of cardiac imagers

Coords also emphasizes the importance of early career involvement in cardiovascular imaging. When he joined SCCT in 2016, it became one of the most important decisions of his professional career.

"It opened many doors for me professionally, and I don't think I'd be where I'm at today if not for joining SCCT," he says.

Today's radiology residents and thoracic imaging fellows are receiving significantly more exposure to CCTA and structural heart CT than previous generations, he notes. As cardiac CT becomes increasingly integrated into routine patient care, understanding both the clinical and operational aspects of these programs will become essential.

"Every resident I speak with now has a pretty solid background," Coords says. "But you need to get involved early in your career because this is something that's going to continue to expand."