Brennen Johnston improving quality of CCTA through technologists and nurse coordinators

As the use of cardiac CT angiography (CCTA) expands rapidly across health systems, imaging leaders are increasingly looking beyond physician expertise to build the multidisciplinary teams needed to deliver consistent, high-quality exams. While physician champions are needed to make these programs successful, technologist champions are equally important.

Brennen Johnston, BASRT(R)(CT), ARRT, radiology director of enterprise advanced cardiac imaging for Advocate Health in Charlotte, North Carolina, discussed the growing role of lead cardiac CT technologists and nurse coordinators with Cardiovascular Business for a new video interview. He said these titles are key to scaling programs while maintaining image quality and patient safety.

A major challenge is that cardiac CT requires a different skill set from general CT. Technologists need additional knowledge of ECG, the circulatory system and detailed cardiac anatomy, while also understanding how to optimize imaging based on each patient's physiology and the capabilities of the scanner.

"There's a little bit more at stake to get it correct the first time," Johnston said, noting that prospectively ECG-gated examinations require careful planning. Poor image quality can reduce physicians' confidence in the study and impact subsequent care decisions.

Scanner technology adds another layer of complexity. Differences between older and newer systems, including wide-detector, dual-source and photon-counting scanners, can influence how exams are performed and the need for medications such as beta blockers to control heart rate.