Appropriate Use Criteria for Cardiac Computed Tomography: Impact on Diagnostic Utility

Bami, Karan; Premaratne, Manuja; Lamba, Jasmine; Yam, Yeung; Hossain, Alomgir; Keenan, Marissa; Haddad, Taleen; Anand, Saipriya; Burwash, Ian G.; Ruddy, Terrence D.; Dwivedi, Girish; Chow, Benjamin J.W.

doi:10.1016/j.cjca.2016.07.309

Cited by 3 publications

(6 citation statements)

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“…In clinical practice, it is important to recognize several pitfalls in interpreting the degree of coronary stenosis. Severe calcifications represent a main obstacle in interpreting the degree of stenosis in a coronary vessel, because of the blooming artifact 5,14–18 . A sharper kernel can be used for the reconstruction of the dataset and could thus help to reduce the blooming artifact.…”

Section: Limitations Of Coronary Cardiac Computed Tomographymentioning

confidence: 99%

“…Whenever the heart rate is very stable and less than 65/min, a high-pitch spiral protocol might be more appropriate. Whenever many extra systoles are present or the heart rate shows high variability, such as in atrial fibrillation, acquisitions in systole should be favored 14–18,69 . Of note, the high-pitch spiral protocol is not without drawbacks, even when the patient has a low heart rate with a minimal heart rate variability 69 .…”

Section: Limitations Of Coronary Cardiac Computed Tomographymentioning

confidence: 99%

“…In this complex and revolutionary scenario, there is a clear need for updating previously published documents on the appropriateness and the clinical/practical use of CCT. [14][15][16][17] Taking into account the existing guidelines and all the available evidence, the Italian Society of Cardiology (SIC) and the Italian Society of Medical and Interventional Radiology (SIRM) endorsed a working group of expert cardiologists and radiologists to conceive of a shared position paper on the appropriate use of CCT, providing a practical approach and novel applications in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Appropriateness criteria for the use of cardiac computed tomography, SIC-SIRM part 2: acute chest pain evaluation; stent and coronary artery bypass graft patency evaluation; planning of coronary revascularization and transcatheter valve procedures; cardiomyopathies, electrophysiological applications, cardiac masses, cardio-oncology and pericardial diseases evaluation

Carrabba

Andreini

Buffa

et al. 2022

Journal of Cardiovascular Medicine

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In the past 20 years, cardiac computed tomography (CCT) has become a pivotal technique for the noninvasive diagnostic workup of coronary and cardiac diseases. Continuous technical and methodological improvements, combined with fast growing scientific evidence, have progressively expanded the clinical role of CCT. Randomized clinical trials documented the value of CCT in increasing the cost-effectiveness of the management of patients with acute chest pain presenting in the emergency department, also during the pandemic. Beyond the evaluation of stents and surgical graft patency, the anatomical and functional coronary imaging have the potential to guide treatment decision-making and planning for complex left main and three-vessel coronary disease. Furthermore, there has been an increasing demand to use CCT for preinterventional planning in minimally invasive procedures, such as transcatheter valve implantation and mitral valve repair. Yet, the use of CCT as a roadmap for tailored electrophysiological procedures has gained increasing importance to assure maximum success. In the meantime, innovations and advanced postprocessing tools have generated new potential applications of CCT from the simple coronary anatomy to the complete assessment of structural, functional and pathophysiological biomarkers of cardiac disease. In this complex and revolutionary scenario, it is urgently needed to provide an updated guide for the appropriate use of CCT in different clinical settings. This manuscript, endorsed by the Italian Society of Cardiology (SIC) and the Italian Society of Medical and Interventional Radiology (SIRM), represents the second of two consensus documents collecting the expert opinion of cardiologists and radiologists about current appropriate use of CCT.

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Section: Limitations Of Coronary Cardiac Computed Tomographymentioning

confidence: 99%

Section: Limitations Of Coronary Cardiac Computed Tomographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Appropriateness criteria for the use of cardiac computed tomography, SIC-SIRM part 2: acute chest pain evaluation; stent and coronary artery bypass graft patency evaluation; planning of coronary revascularization and transcatheter valve procedures; cardiomyopathies, electrophysiological applications, cardiac masses, cardio-oncology and pericardial diseases evaluation

Carrabba

Andreini

Buffa

et al. 2022

Journal of Cardiovascular Medicine

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“…4 In comparison with other current imaging modalities, the cardiac MRI and CT have higher spatial resolution than RT3DE. 5,6 Another disadvantage of RT3DE is related with LA appendage. It has a considerable role for the function of LA.…”

Section: Left Atrium Volume and Measurementsmentioning

confidence: 99%

Overview of left atrium phasic volumes using real time three dimensional echocardiography

Kanar¹

2019

JCCR

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The reservoir, conduit, and contractile phasic volumes and functions of the left atrium (LA) are important to understand overall cardiac performance. As far as recent studies are concerned, the accurate assessment of LA phasic functions and structure, using techniques such as conventional two-dimensional echocardiography (2D-echo), real time three dimensional echocardiography (RT3DE), color tissue Doppler imaging (TDI), and speckle tracking echocardiography (STE), as well as cardiac computed tomography (CT) and magnetic resonance imaging (MRI). This review article explains how to determine the LA volume and functions using RT3DE and emphases their relationship with current diseases.

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“…The Appropriate Use Criteria (AUC) were introduced by the American College of Cardiology Foundation in response to growing concern regarding potential overutilization of non-invasive cardiac imaging [1][2][3]. The aim of the AUC is to provide guidance to physicians with diagnostic test selection while optimizing scarce resources and healthcare expenditures [4].…”

Section: Introductionmentioning

confidence: 99%

Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease

Hammer

Mian

Elhadad

et al. 2021

BMC Cardiovasc Disord

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Background Appropriate use criteria (AUC) have been developed in response to growth in cardiac imaging utilization and concern regarding associated costs. Cardiac computed tomography angiography (CCTA) has emerged as an important modality in the evaluation of coronary artery disease, however its appropriate utilization in actual practice is uncertain. Our objective was to determine the appropriate utilization of CCTA in a large quaternary care institution and to compare appropriate utilization pre and post publication of the 2013 AUC guidelines. We hypothesized that the proportion of appropriate CCTA utilization will be similar to those of other comparable cardiac imaging modalities and that there would be a significant increase in appropriate use post AUC publication. Methods We employed a retrospective cohort study design of 2577 consecutive patients undergoing CCTA between January 1, 2012 and December 30, 2016. An appropriateness category was assigned for each CCTA. Appropriateness classifications were compared pre- and post- AUC publication via the chi-square test. Results Overall, 83.5% of CCTAs were deemed to be appropriate based on the AUC. Before the AUC publication, 75.0% of CCTAs were classified as appropriate whereas after the AUC publication, 88.0% were classified as appropriate (p < 0.001). The increase in appropriate utilization, when extrapolated to the Medicare population of the United States, was associated with potential cost savings of approximately $57 million per year. Conclusions We report a high rate of appropriate use of CCTA and a significant increase in the proportion of CCTAs classified as appropriate after the AUC publication.

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Appropriate Use Criteria for Cardiac Computed Tomography: Impact on Diagnostic Utility

Cited by 3 publications

References 0 publications

Overview of left atrium phasic volumes using real time three dimensional echocardiography

Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease

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