Multislice/spiral computed tomography for screening for coronary artery disease

Multislice computed tomography (MSCT) and spiral (or helical) computed tomography (CT) are designed to provide faster images with better resolution than conventional CT scanning. MSCT and spiral CT have been used to quantify calcification in the coronary arteries, in an effort to link this to coronary artery disease. Long-term studies on clinical outcomes of people screened with MSCT or spiral CT are lacking, as are comparisons with established screening modalities like risk factor algorithms. Low specificity gives rise to concern over false positive results. False positives may cause harm (and expense) due to inappropriate and invasive follow-up. One study was identified in which spiral CT was compared with electron beam CT (EBCT) to evaluate coronary calcifications in 33 asymptomatic individuals, giving a sensitivity of 74% and a specificity of 70%. There is insufficient evidence at this time to suggest that asymptomatic people derive clinical benefit from undergoing coronary calcification screening using MSCT or spiral CT scanning.