Healthcare Policy Statement on the Utility of Coronary Computed Tomography for Evaluation of Cardiovascular Conditions and Preventive Healthcare: From the Health Policy Working Group of the Society of Cardiovascular Computed Tomography.

The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year.

The Need for Standardized Methods for Measuring the Aorta: Multimodality Core Lab Experience From the GenTAC Registry.

Objectives: This study sought to evaluate variability in aortic measurements with multiple imaging modalities in clinical centers by comparing with a standardized measuring protocol implemented in a core laboratory.

Background: In patients with aortic disease, imaging of thoracic aorta plays a major role in risk stratifying individuals for life-threatening complications and in determining timing of surgical intervention. However, standardization of the procedures for performance of aortic measurements is lacking.

Noninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient: The Imaging Council of the American College of Cardiology.

Increased cardiovascular morbidity and mortality in patients with type 2 diabetes is well established; diabetes is associated with at least a 2-fold increased risk of coronary heart disease. Approximately two-thirds of deaths among persons with diabetes are related to cardiovascular disease. Previously, diabetes was regarded as a "coronary risk equivalent," implying a high 10-year cardiovascular risk for every diabetes patient.

Cardiac CT for planning redo cardiac surgery: effect of knowledge-based iterative model reconstruction on image quality.

Objectives: The purpose of this study was to investigate the effects of knowledge-based iterative model reconstruction (IMR) on image quality in cardiac CT performed for the planning of redo cardiac surgery by comparing IMR images with images reconstructed with filtered back-projection (FBP) and hybrid iterative reconstruction (HIR).

Methods: We studied 31 patients (23 men, 8 women; mean age 65.1 ± 16.

Physiologic evaluation of ischemia using cardiac CT: current status of CT myocardial perfusion and CT fractional flow reserve.

Cardiac CT, specifically coronary CT angiography (CTA), is an established technology which detects anatomically significant coronary artery disease with a high sensitivity and negative predictive value compared with invasive coronary angiography. However, the limited ability of CTA to determine the physiologic significance of intermediate coronary stenoses remains a shortcoming compared with other noninvasive methods such as single-photon emission CT, stress echocardiography, and stress cardiac magnetic resonance. Two methods have been investigated recently: (1) myocardial CT perfusion and (2) fractional flow reserve (FFR) computed from CT (FFRCT).

Iterative model reconstruction: improved image quality of low-tube-voltage prospective ECG-gated coronary CT angiography images at 256-slice CT.

Objectives: To investigate the effects of a new model-based type of iterative reconstruction (M-IR) technique, the iterative model reconstruction, on image quality of prospectively gated coronary CT angiography (CTA) acquired at low-tube-voltage.

Methods: Thirty patients (16 men, 14 women; mean age 52.2 ± 13.

Scout view X-ray attenuation versus weight-based selection of reduced peak tube voltage in cardiac CT angiography.

Objectives: The study evaluated the relationship between cardiac computed tomography (CT) scout view x-ray attenuation and CT image noise compared with weight or body mass index (BMI).

Background: Decreasing peak tube voltage from 120 to 100 kVp on the basis of body size reduces radiation exposure. Methods to better predict CT image noise may lead to more effective selection of reduced tube voltage in cardiac CT.

State-of-the-art in CT hardware and scan modes for cardiovascular CT.

Multidetector row computed tomography (CT) allows noninvasive anatomic and functional imaging of the heart, great vessels, and coronary arteries. In recent years, there have been several advances in CT hardware, which have expanded the clinical utility of CT for cardiovascular imaging; such advances are ongoing. This review article from the Society of Cardiovascular Computed Tomography Basic and Emerging Sciences and Technology Working Group summarizes the technical aspects of current state-of-the-art CT hardware and describes the scan modes this hardware supports for cardiovascular CT imaging.

Prospective evaluation of the updated 2010 ACCF Cardiac CT Appropriate Use Criteria.

Background: The cardiac CT Appropriate Use Criteria (AUC) were updated in 2010 to reflect technical advances, evolving expert consensus, and rapidly expanding clinical evidence.

Objective: We evaluated the effect of the AUC update on their clinical performance, including the completeness and distribution of appropriateness ratings and test outcomes among a consecutive series of patients referred for CT angiography (CTA).

Methods: The 2006 and 2010 criteria were prospectively applied at the point of service to a consecutive series of patients referred for CTA at a single center (n = 1216).

Effect of hybrid iterative reconstruction technique on quantitative and qualitative image analysis at 256-slice prospective gating cardiac CT.

Objectives: To evaluate the effect of hybrid iterative reconstruction on qualitative and quantitative parameters at 256-slice cardiac CT.

Methods: Prospective cardiac CT images from 20 patients were analysed. Paired image sets were created using 3 reconstructions, i.

Standardized medical terminology for cardiac computed tomography: a report of the Society of Cardiovascular Computed Tomography.

Since the emergence of cardiac computed tomography (CT) at the turn of the 21st century, there has been an exponential growth in research and clinical development of the technique, with contributions from investigators and clinicians from varied backgrounds: physics and engineering, informatics, cardiology, and radiology. However, terminology for the field is not unified. As a consequence, there are multiple abbreviations for some terms, multiple terms for some concepts, and some concepts that lack clear definitions and/or usage.

Prosthetic mitral valve thrombosis: cardiac CT, 3-dimensional transesophageal echocardiogram, and pathology correlation.

Images in cardiovascular computed tomography display prosthetic mitral valve thrombosis with cardiac CT, 3-dimensional transesophageal echocardiography, and pathology correlation.

Ultra-low-dose intra-arterial contrast injection for iliofemoral computed tomographic angiography.

Objectives: This study sought to evaluate the feasibility of using ultra-low-dose intra-arterial contrast injection for iliofemoral computed tomographic (CT) angiography to follow diagnostic cardiac catheterization.

Background: Cardiovascular interventions such as percutaneous aortic valve replacement require transfemoral delivery of large-bore intra-arterial catheters; therefore, pre-procedural assessment of aortoiliofemoral anatomy is important. CT angiography is ideal for this purpose but requires a large volume of intravenous contrast.

Accuracy of computed tomographic angiography for stenosis quantification using quantitative coronary angiography or intravascular ultrasound as the gold standard.

Computed tomographic angiography (CTA) is considered to have limited accuracy for quantifying exact percent diameter stenosis in coronary arteries. However, most studies evaluating CTA use quantitative coronary angiography (QCA) as the gold standard, a technique with its own limitations. We sought to determine whether CTA measurements of stenosis severity correlate better with intravascular ultrasound (IVUS) than with QCA.

Evaluation of myocardial viability by multidetector CT.

The continued advancement of multidetector computed tomography (MDCT) has launched an exciting new method for myocardial viability imaging. This article aims to present data validating MDCT for viability imaging, to demonstrate MDCT's prognostic clinical value, and to delineate its potential clinical applications.

The predictive value of computed tomography calcium scores: a comparison with quantitative volumetric intravascular ultrasound.

Objective: To evaluate the relationship between coronary artery calcium scoring (CACS) and intravascular ultrasound (IVUS) calcification and disease severity.

Methods: Forty-five angina patients who underwent CACS 18+/-23 days before IVUS were studied. The CACS was recorded for each lesion matched to a specific IVUS lesion.

Comparison of intravascular ultrasound to contrast-enhanced 64-slice computed tomography to assess the significance of angiographically ambiguous coronary narrowings.

The efficacy of contrast-enhanced multislice computed tomography (MSCT) for assessment of ambiguous lesions is unknown. We compared both quantitative coronary angiography (QCA) and MSCT to the gold standard for a significant stenosis-minimum luminal area (MLA) by intravascular ultrasound (IVUS)-in 51 patients (64 +/- 10 years old, 19 men) with 69 angiographically ambiguous, nonleft main lesions. The MSCT was performed 17 +/- 18 days before IVUS analysis.