Coronary CT angiography alone versus with CT perfusion: a systematic review and meta-analysis assessing approaches for chest pain.

Objectives: To evaluate the prognostic value of stress Computed Tomography Perfusion (CTP) in patients with suspected or known coronary artery disease.

Materials And Methods: All studies evaluating patients with chest pain with CTP plus coronary computed tomography angiography (CCTA) alone or versus CCTA were included. The primary analysis included studies comparing CCTA plus CTP vs CCTA alone, while in the secondary analysis we analyzed the incidence of each outcome across all seven studies, two- and single-arm.

Clinical impact of CCT-FFR as first-strategy in patients with symptomatic stable coronary artery disease: A systematic review and meta-analysis.

Despite the promising results, the clinical implications of the CCT-FFR is already debated. This metanalysis aimed to determine the potential benefits of incorporating FFRCT into stable CAD management. After searching for studies comparing outcomes of patients with suspected stable CAD who underwent CCT-FFR as a first strategy versus non-urgent cardiovascular testing after a clinical judgment, we calculated odds ratios (ORs) and 95 ​% confidence intervals (CIs) using a random-effects or fixed-effects meta-analysis model depending on heterogeneity significance.

Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.

Objectives: To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.

Methods: A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables.

Digitalised multidisciplinary conferences effectively identify and prevent imaging-related medical error in intensive care patients during the COVID-19 pandemic.

This study aims to assess the effectiveness of digital multidisciplinary conferences (MDCs) in preventing imaging-related quality management (QM) events during the coronavirus-disease-19 (COVID-19) pandemic. COVID-19 challenged interdisciplinary exchange and QM measures for patient safety. Regular MDCs between radiologists and intensive care unit (ICU) physicians, introduced in our hospital in 2018, enable re-evaluation of imaging examinations and bilateral feedback.

Prognostic Value of Coronary CT Angiography-Derived Quantitative Flow Ratio in Suspected Coronary Artery Disease.

Background The prognostic value of coronary CT angiography (CTA)-derived quantitative flow ratio (CT-QFR) remains unknown. Purpose To determine the prognostic value of CT-QFR in predicting the long-term outcomes of patients with suspected coronary artery disease (CAD) in comparison with invasive coronary angiography (ICA)/SPECT and to determine the influence of prior percutaneous coronary intervention (PCI) on the prognostic value of CT-QFR. Materials and Methods In this secondary analysis of the prospective international CORE320 study, 379 participants who underwent coronary CTA and SPECT within 60 days before ICA between November 2009 and July 2011 were included for follow-up.

[Current guidelines for chronic coronary syndrome : Role of computed tomography-coronary angiography and pretest probability for coronary artery disease].

Due to its high sensitivity and high negative predictive value, computed tomography angiography of the coronary arteries (CCTA) has proven to be particularly useful for ruling out obstructive coronary artery disease (CAD) in cases of suspected chronic coronary syndrome (CCS), which is why CCTA will also be included in the care of patients with statutory health insurance in Germany according to the G-BA decision of January 24, 2024. The value of CCTA is clearly confirmed in the current guidelines of the European Society of Cardiology (ESC) and the national care guideline from August 2024. However, good results from CCTA can only be achieved-in addition to appropriate qualifications of those performing the test and the necessary technical requirements-if the right patients are included, namely those with a low intermediate pretest probability for the presence of obstructive CAD.

Predictors of residual tricuspid regurgitation after interventional therapy: an automated deep-learning CT analysis.

Computed tomography (CT) is used as a valuable tool for device selection for interventional therapy in tricuspid regurgitation (TR). We aimed to evaluate predictors of TR reduction using CT and automated deep learning algorithms. Patients with severe to torrential TR and CTs prior to either percutaneous annuloplasty (PA) or tricuspid transcatheter edge-to-edge repair (T-TEER) were enrolled.

Quality Assessment for Secondary Use of Imaging Trials.

Secondary use of health data has become an emerging topic in medical informatics. Many initiatives focus on clinical routine data, but clinical trial data has complementary strengths regarding highly structured documentation and mandatory data quality (DQ) reviews during the implementation. Clinical imaging trials investigate new imaging methods and procedures.

The effectiveness of coronary computed tomography angiography and functional testing for the diagnosis of obstructive coronary artery disease: results from the individual patient data Collaborative Meta-Analysis of Cardiac CT (COME-CCT).

Aim: To determine the effectiveness of functional stress testing and computed tomography angiography (CTA) for diagnosis of obstructive coronary artery disease (CAD).

Methods And Results: Two-thousand nine-hundred twenty symptomatic stable chest pain patients were included in the international Collaborative Meta-Analysis of Cardiac CT consortium to compare CTA with exercise electrocardiography (exercise-ECG) and single-photon emission computed tomography (SPECT) for diagnosis of CAD defined as ≥ 50% diameter stenosis by invasive coronary angiography (ICA) as reference standard. Generalised linear mixed models were used for calculating the diagnostic accuracy of each diagnostic test including non-diagnostic results as dependent variables in a logistic regression model with random intercepts and slopes.

Radiomics workflow definition & challenges - German priority program 2177 consensus statement on clinically applied radiomics.

Objectives: Achieving a consensus on a definition for different aspects of radiomics workflows to support their translation into clinical usage. Furthermore, to assess the perspective of experts on important challenges for a successful clinical workflow implementation.

Materials And Methods: The consensus was achieved by a multi-stage process.

Computed tomography in patients with sepsis presenting to the emergency department: exploring its role in light of patient outcomes.

Objectives: This study aimed to explore the role of CT in septic patients presenting to the emergency department (ED).

Materials And Methods: We performed a retrospective secondary analysis of 192 septic patients from a prospective observational study, i.e.

Automated graded prognostic assessment for patients with hepatocellular carcinoma using machine learning.

Background: Accurate mortality risk quantification is crucial for the management of hepatocellular carcinoma (HCC); however, most scoring systems are subjective.

Purpose: To develop and independently validate a machine learning mortality risk quantification method for HCC patients using standard-of-care clinical data and liver radiomics on baseline magnetic resonance imaging (MRI).

Methods: This retrospective study included all patients with multiphasic contrast-enhanced MRI at the time of diagnosis treated at our institution.

Coronary Artery Calcium Score Predicts Major Adverse Cardiovascular Events in Stable Chest Pain.

Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Purpose To assess the prognostic value of CAC scoring for MACE in participants with stable chest pain initially referred for invasive coronary angiography (ICA). Materials and Methods This prespecified subgroup analysis from the Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial, conducted between October 2015 and April 2019 across 26 centers in 16 countries, focused on adult patients with stable chest pain referred for ICA.

Age and Computed Tomography and Invasive Coronary Angiography in Stable Chest Pain: A Prespecified Secondary Analysis of the DISCHARGE Randomized Clinical Trial.

Importance: The effectiveness and safety of computed tomography (CT) and invasive coronary angiography (ICA) in different age groups is unknown.

Objective: To determine the association of age with outcomes of CT and ICA in patients with stable chest pain.

Design, Setting, And Participants: The assessor-blinded Diagnostic Imaging Strategies for Patients With Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) randomized clinical trial was conducted between October 2015 and April 2019 in 26 European centers.

Patient satisfaction with coronary CT angiography versus invasive coronary angiography: results of a single-center randomized trial.

Objective: Because there is evidence for a clinical benefit of using coronary computed tomography (CT) angiography instead of invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD), we ascertained if patient satisfaction could represent an important barrier to implementation of coronary CT in clinical practice.

Materials And Methods: A total of 329 patients with suspected CAD and clinical indication for ICA were randomly assigned to undergo either CT or ICA for guiding treatment. Satisfaction for both groups was assessed by patient questionnaire completed twice, ≥24 h after CT or ICA, and at follow-up after a median of 3.

Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial.

Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019.