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Multislice/spiral computed tomography for screening for coronary artery disease
Issues in Emerging Health Technologies
|March 7, 2003
Summary
Multislice computed tomography (MSCT) and spiral CT scans for coronary artery calcification screening lack long-term outcome data. Current evidence is insufficient to recommend these advanced CT scans for asymptomatic individuals due to concerns about false positives.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Multislice computed tomography (MSCT) and spiral computed tomography (CT) offer improved image speed and resolution over conventional CT.
- These advanced CT techniques are utilized for quantifying coronary artery calcification (CAC) to assess coronary artery disease (CAD) risk.
- However, long-term clinical outcome data and comparisons with established screening methods are limited.
Purpose of the Study:
- To evaluate the current evidence regarding the clinical utility of MSCT and spiral CT for coronary calcification screening in asymptomatic individuals.
- To identify gaps in knowledge concerning the long-term benefits and risks associated with these screening modalities.
Main Methods:
- A review of existing studies comparing MSCT or spiral CT with conventional CT or other screening modalities was conducted.
- One identified study compared spiral CT with electron beam CT (EBCT) for coronary calcification evaluation in asymptomatic subjects.
Main Results:
- The reviewed literature indicates a lack of long-term outcome studies for MSCT and spiral CT screening.
- One comparative study reported a sensitivity of 74% and a specificity of 70% for spiral CT in detecting coronary calcifications.
- Concerns exist regarding the low specificity of these methods, potentially leading to false positives and subsequent unnecessary invasive procedures.
Conclusions:
- There is insufficient evidence to support the routine use of MSCT or spiral CT for coronary calcification screening in asymptomatic populations.
- The potential harms and costs associated with false-positive results warrant caution.
- Further research is needed to establish the long-term clinical benefits and optimal role of these advanced CT techniques in cardiovascular risk assessment.