Coronary CT angiography – current options and future perspectives in the diagnosis of coronary artery disease
Authors:
Jan Baxa; Jiří Ferda
Authors‘ workplace:
Klinika zobrazovacích metod LF UK a FN Plzeň
Published in:
Čas. Lék. čes. 2018; 157: 181-187
Category:
Review Article
Overview
Computed tomography (CT) is currently an imaging method with a very wide use in acute and chronic diagnostics. Technological development of the method has gradually enabled a good view of the coronary flow in a noninvasive way. The article summarizes the current possibilities of coronary CT angiography, a proven method for the detection of coronary atherosclerosis. Its main advantage is particularly a simplicity and a design safety and potentially a high availability.
An ever-increasing number of clinical trials has been validating the possible relevance of CT angiography in a variety of clinical situations and it is highly probable to expect a widening of the spectrum of indications, particularly in a group of patients with a higher pretest probability of coronary artery disease. At the same time, it can be expected to be an essential method in acute diagnosis with the necessity of its permanent availability in acute care. The above-mentioned facts will lead to the need for targeted coordination of performing radiological workplaces, particularly in complex cardiovascular centers, to ensure the quality and availability of the method with respect to the probable increase in the number of method’s indications.
Keywords:
CT angiography; coronary arteries; coronary artery disease
Sources
1. Flohr TG, Ohnesorge BM. Imaging of the heart with computed tomography. Basic Res Cardiol 2008; 103: 161–173.
2. Baxa J, Ferda J. Multidetektorová výpočetní tomografie srdce. Galén, Praha, 2012.
3. Flohr TG, Raupach R, Bruder H. Cardiac CT: How much can temporal resolution, spatial resolution, and volume coverage be improved? J Cardiovasc Comput Tomogr 2009; 3: 143–152.
4. Fishman EK, Reddan D. What are radiologists doing to prevent contrast-induced nephropathy (CIN) compared with measures supported by current evidence? A survey of European radiologists on CIN associated with computed tomography. Acta Radiol 2008; 49: 310–320.
5. Alkadhi H, Leschka S. Radiation dose of cardiac computed tomography – what has been achieved and what needs to be done. Eur Radiol 2011; 21: 505–509.
6. Cury RC, Abbara S, Achenbach S et al. Coronary Artery Disease – Reporting and Data System (CAD-RADS): An Expert Consensus Document of SCCT, ACR and NASCI: Endorsed by the ACC. JACC Cardiovasc Imaging 2016; 9: 1099–1113.
7. Foldyna B, Szilveszter B, Scholtz JE et al. CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography. Eur Radiol 2018; 28: 1365–1372.
8. Salavati A, Radmanesh F, Heidari K et al. Dual-source computed tomography angiography for diagnosis and assessment of coronary artery disease: systematic review and meta-analysis. J Cardiovasc Comput Tomogr 2012; 6: 78–90.
9. Meijboom WB, Van Mieghem CA, Mollet NR et al. 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol 2007; 50: 1469–75.
10. Achenbach S. Coronary CT angiography-future directions. Cardiovasc Diagn Ther 2017; 7: 432–438.
11. Min JK, Dunning A, Lin FY et al. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol 2011; 58: 849–860.
12. Hadamitzky M, Täubert S, Deseive S et al. Prognostic value of coronary computed tomography angiography during 5 years of follow-up in patients with suspected coronary artery disease. Eur Heart J 2013; 34: 3277–3285.
13. Douglas PS, Hoffmann U. Anatomical versus Functional Testing for Coronary Artery Disease. N Engl J Med 2015; 373: 91.
14. Menke J, Kowalski J. Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose. Eur Radiol 2016; 26: 451–458.
15. SCOT-HEART investigators. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet 2015; 385: 2383–2391.
16. Bittner DO, Ferencik M, Douglas PS, Hoffmann U. Coronary CT angiography as a diagnostic and prognostic tool: perspective from a multicenter randomized controlled trial: PROMISE. Curr Cardiol Rep 2016; 18: 40.
17. Roffi M, Patrono C, Collet JP et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2016; 37: 267–315.
18. Al-Mallah MH, Aljizeeri A, Villines TC et al. Cardiac computed tomography in current cardiology guidelines. J Cardiovasc Comput Tomogr 2015; 9: 514–523.
19. Ayaram D, Bellolio MF, Murad MH et al. Triple rule-out computed tomographic angiography for chest pain: a diagnostic systematic review and meta-analysis. Acad Emerg Med 2013; 20: 861–871.
20. Williams MC, Hunter A, Shah ASV et al. Use of coronary computed tomographic angiography to guide management of patients with coronary disease. J Am Coll Cardiol 2016; 67: 1759–1768.
21. Wolk MJ, Bailey SR, Doherty JU et al. ACCF/AHA/ASNC/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force. J Am Coll Cardiol 2014; 63: 380–406.
22. Lee SK, Jung JI, Ko JM, Lee HG. Image quality and radiation exposure of coronary CT angiography in patients after coronary artery bypass graft surgery: influence of imaging direction with 64-slice dual-source CT. J Cardiovasc Comput Tomogr 2014; 8: 124–130.
23. Baxa J, Ferda J, Pešek J et al. Zobrazení aortokoronárních bypassů pomocí multidetektorové CT-angiografie: retrospektivní analýza 250 vyšetření. Česká radiologie 2007; 61: 97–104.
24. Chow BJ, Small G, Yam Y et al. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) registry. Arterioscler Thromb Vasc Biol 2015; 35: 981–989.
25. Rochitte CE, George RT, Chen MY et al. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography: the CORE320 study. Eur Heart J 2014; 35: 1120–1130.
26. Baxa J, Hromádka M, Šedivý J et al. Regadenoson-stress dynamic myocardial perfusion improves diagnostic performance of CT angiography in assessment of intermediate coronary artery stenosis in asymptomatic patients. Biomed Res Int 2015; 2015: 105629.
27. Nørgaard BL, Jensen JM, Blanke P et al. Coronary CT angiography derived fractional flow reserve: the game changer in noninvasive testing. Curr Cardiol Rep 2017; 19: 112.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
Most read in this issue
- Hybrid imaging PET/MR in prostatic carcinoma
- Coronary CT angiography – current options and future perspectives in the diagnosis of coronary artery disease
- Contrast-enhanced ultrasonography
- Interventional radiology therapies for liver cancer