All High-Risk Patients Should Not Be Screened With Computed Tomographic Angiography

Kramer, Christopher M.

doi:10.1161/circulationaha.107.670059

Cited by 9 publications

(10 citation statements)

References 73 publications

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“…This feature is known as the K‐edge. As many clinical scans are performed at a tube voltage of 80 kV, the K‐edge of iodine is strongly influential on its attenuation and the greater attenuation advantage of gold from its higher Z ‐value is erased, with approximately equal attenuation from the two elements observed in practice .…”

Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

“…A limitation of CT is its low sensitivity to contrast compared with other imaging techniques. The detection limit for CT is about 10 −3 m , whereas for MRI it is about 10 −5 m for gadolinium chelates and for nuclear techniques about 10 −9 m . This is because, for CT, the contrast agent is being directly detected against a high background signal.…”

Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

“…Comparisons of, or simulations run on the distribution of the X‐ray beam and the attenuation profile will give a reasonable idea of the performance of the contrast agent at different energies. For example, the K‐edge of iodine is at 33.2 keV, so iodine gives stronger contrast when scanned at 80 kV than 120 kV, as in the latter case more of the X‐rays are in a region of the spectrum where iodine absorbs poorly . On the other hand, the K‐edge of gold is at 80.7 keV, meaning that it absorbs X‐rays strongly in the 80–120 keV region and hence it provides stronger contrast when scanned at 120 kV than at 80 kV.…”

Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

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Nanoparticle contrast agents for computed tomography: a focus on micelles

Cormode

Naha

Fayad

2014

Contrast Media & Molecular

293

234

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Computed tomography (CT) is an X-ray based whole body imaging technique that is widely used in medicine. Clinically approved contrast agents for CT are iodinated small molecules or barium suspensions. Over the past seven years there has been a great increase in the development of nanoparticles as CT contrast agents. Nanoparticles have several advantages over small molecule CT contrast agents, such as long blood-pool residence times, and the potential for cell tracking and targeted imaging applications. Furthermore, there is a need for novel CT contrast agents, due to the growing population of renally impaired patients and patients hypersensitive to iodinated contrast. Micelles and lipoproteins, a micelle-related class of nanoparticle, have notably been adapted as CT contrast agents. In this review we discuss the principles of CT image formation and the generation of CT contrast. We discuss the progress in developing non-targeted, targeted and cell tracking nanoparticle CT contrast agents. We feature agents based on micelles and used in conjunction with spectral CT. The large contrast agent doses needed will necessitate careful toxicology studies prior to clinical translation. However, the field has seen tremendous advances in the past decade and we expect many more advances to come in the next decade.

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Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

Section: Principles Of Ct Contrast Generationmentioning

confidence: 99%

See 1 more Smart Citation

Nanoparticle contrast agents for computed tomography: a focus on micelles

Cormode

Naha

Fayad

2014

Contrast Media & Molecular

293

234

View full text Add to dashboard Cite

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“…45 The small risk of radiation exposure and contrast administration limits the implementation of the test in large screening studies for coronary artery disease in the general population. 46 Patients undergoing thoracic aortic repair are, however, different and have a higher a priori risk of coronary artery disease than individuals from the general population. Another difference is that the ECG-gated CT can be performed instead of the regular nongated CTA, which almost all of these patients would undergo otherwise.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous sizing and preoperative risk stratification for thoracic endovascular aneurysm repair: Role of gated computed tomography

Schlösser

Mojibian

Dardik

et al. 2008

Journal of Vascular Surgery

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This study introduces the feasibility of dynamic imaging of the thoracic aorta and cardiac structures and function, including the coronary arteries, with just one CT scan. The images could be successfully assessed for thoracic aorta pathology, cardiac disease, and extracardiac pathology. With further developments of CT scanners-and more detailed insight in the prognosis of patients based on ECG-gated CTA findings-this new technique may become the initial imaging modality for preoperative cardiac risk stratification in patients with TAAs or dissections.

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“…Redberg and Walsh [8] and Redberg [9] expressed concern about the "exploding use" of coronary CTA and that we do not yet know enough about how it changes patient management or leads to better outcomes. Others have expressed concern about the exposure to radiation and contrast material [10] as well as cost [11].…”

mentioning

confidence: 99%

The Lack of Growth in Use of Coronary CT Angiography: Is It Being Appropriately Used?

Levin

Parker

Halpern

et al. 2011

American Journal of Roentgenology

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Given that coronary CTA is a new procedure that has aroused much interest and has been shown to have very favorable results, the drop in its utilization rate in 2008 was surprising. A review of the literature indicates that there are shortcomings to the clinical diagnosis of coronary artery disease (which often includes the use of MPI), that coronary CTA can be used to stratify risk, and that it can expedite the workup of patients with acute chest pain in emergency departments. The evidence from the literature review suggests that both invasive coronary angiography and MPI may be overutilized, whereas coronary CTA is probably underutilized.

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All High-Risk Patients Should Not Be Screened With Computed Tomographic Angiography

Cited by 9 publications

References 73 publications

Nanoparticle contrast agents for computed tomography: a focus on micelles

Nanoparticle contrast agents for computed tomography: a focus on micelles

Simultaneous sizing and preoperative risk stratification for thoracic endovascular aneurysm repair: Role of gated computed tomography

The Lack of Growth in Use of Coronary CT Angiography: Is It Being Appropriately Used?

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