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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

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Published on: August 28, 2018

Appropriate indications for computed tomography coronary angiography

Gary Y H Liew1, Michael P Feneley, Stephen G Worthley

  • 1Cardiac CT Service, Royal Adelaide Hospital, Adelaide, SA. gary.liew@adelaide.edu.au

The Medical Journal of Australia
|March 14, 2012
PubMed

Insights

Computed tomography coronary angiography (CTCA) effectively rules out coronary artery disease (CAD) in symptomatic patients with low to intermediate risk. Modern CTCA protocols offer radiation doses comparable to invasive angiography.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Computed tomography coronary angiography (CTCA) is a non-invasive imaging technique.
  • Multicenter trials have established CTCA's reliability in excluding significant coronary artery disease (CAD).

Purpose of the Study:

  • To define the appropriate use cases for CTCA in diagnosing coronary artery disease.
  • To compare the radiation dose of CTCA with invasive coronary angiography.

Main Methods:

  • Review of multicenter trial data on CTCA efficacy.
  • Analysis of patient selection criteria for optimal CTCA use.
  • Comparison of radiation dosimetry between CTCA and invasive coronary angiography.

Main Results:

  • CTCA is highly reliable for ruling out significant CAD in specific patient groups.
  • Appropriate use is in symptomatic patients with low to intermediate pretest probability of CAD.
  • Radiation dose with modern CTCA protocols is similar to or lower than invasive angiography.

Conclusions:

  • CTCA is a valuable tool for excluding significant CAD when used appropriately.
  • CTCA should not be used in asymptomatic individuals or those with known or high-probability CAD.
  • Patient selection and adherence to protocol (sinus rhythm, heart rate < 65 bpm, breath-hold capacity) are crucial for successful CTCA.

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