Indications and reimbursement of cardiac computed tomography angiography: History, present and future perspectives

Shen, M.-H. Herman; Saxena, N.; Thomas, Gregory S.

doi:10.1016/j.jcct.2007.11.004

Cited by 7 publications

(3 citation statements)

References 11 publications

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“…It has been shown in many studies that CTA has very high negative predictive value (93% to 100%). Therefore, cardiac CTA is usually used for evaluating people at low to intermediate risk of coronary artery disease [40] – [42] . Thus, patient for whom the value of coronary CTA is maximized are more likely to be represented by the normal subjects in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Seismocardiography-Based Cardiac Computed Tomography Gating Using Patient-Specific Template Identification and Detection

Yao

Tridandapani

Wick

et al. 2017

IEEE J. Transl. Eng. Health Med.

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To more accurately trigger cardiac computed tomography angiography (CTA) than electrocardiography (ECG) alone, a sub-system is proposed as an intermediate step toward fusing ECG with seismocardiography (SCG). Accurate prediction of quiescent phases is crucial to prospectively gating CTA, which is susceptible to cardiac motion and, thus, can affect the diagnostic quality of images. The key innovation of this sub-system is that it identifies the SCG waveform corresponding to heart sounds and determines their phases within the cardiac cycles. Furthermore, this relationship is modeled as a linear function with respect to heart rate. For this paper, B-mode echocardiography is used as the gold standard for identifying the quiescent phases. We analyzed synchronous ECG, SCG, and echocardiography data acquired from seven healthy subjects (mean age: 31; age range: 22–48; males: 4) and 11 cardiac patients (mean age: 56; age range: 31–78; males: 6). On average, the proposed algorithm was able to successfully identify 79% of the SCG waveforms in systole and 68% in diastole. The simulated results show that SCG-based prediction produced less average phase error than that of ECG. It was found that the accuracy of ECG-based gating is more susceptible to increases in heart rate variability, while SCG-based gating is susceptible to high cycle to cycle variability in morphology. This pilot work of prediction using SCG waveforms enriches the framework of a comprehensive system with multiple modalities that could potentially, in real time, improve the image quality of CTA.

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Section: Discussionmentioning

confidence: 99%

Seismocardiography-Based Cardiac Computed Tomography Gating Using Patient-Specific Template Identification and Detection

Yao

Tridandapani

Wick

et al. 2017

IEEE J. Transl. Eng. Health Med.

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“…As expected, they can provide quantitative information for a biological event in vivo with ultrahigh sensitivity. [ 104 ] Positron emission tomography and single‐photon emission computed tomography (SPECT) are considered important parts of nuclear imaging technology, which have been devoted to fundamental biological research and clinical diagnostics. Currently, the nuclear‐targeted imaging by CDs with target‐specific agents represents one of the most significant approaches.…”

Section: Tumour Diagnosis Of Cdsmentioning

confidence: 99%

Applications of carbon dots on tumour theranostics

et al. 2021

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Carbon dots (CDs) have been extensively investigated as prime candidates for developing tumour theranostic platform due to their tunable fluorescence emission and excitation, good photostability, high water solubility and biocompatibility. Herein, we will update the recent research and latest development on the preparation, hydrophilicity, biotoxicity and optical property of CDs, as well as their applications in multimodal bioimaging and anticancer drug delivery. We will mainly highlight their applications in in vivo imaging and tumour‐targeted theranostics with a special emphasis on large amino acid‐mimicking carbon quantum dots‐based tumour theranostics through a large neutral amino acid transporter 1 (LAT1)‐mediated targeted strategy. Finally, we will also discuss the current status, key challenges and future directions of CDs in tumour theranostics. We expect that this review will summarize recent advances to inspire more researches on CDs for biomedical and clinical applications in the near future.

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“…It is certainly not a widespread replacement for diagnostic invasive coronary angiography, nor a screening technique, but if image quality is adequate (which requires that state-of-theart equipment is used and adequate imaging protocols are applied) and patients are appropriately selected, coronary CTA is considered clinically useful in a number of welldefined situations (1)(2)(3). Such situations include patients presenting with acute chest pain at an intermediate likelihood of coronary artery disease, with an absence of electrocardiographic (ECG) changes and normal troponin values, or patients with stable chest pain at intermediate likelihood of coronary artery disease, but with equivocal stress test results.…”

mentioning

confidence: 99%

Stress Computed Tomography Myocardial Perfusion

Achenbach

2009

Journal of the American College of Cardiology

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Coronary computed tomographic angiography (CTA) is establishing itself as a method that allows robust visualization of the coronary arteries in a noninvasive fashion. It is certainly not a widespread replacement for diagnostic invasive coronary angiography, nor a screening technique, but if image quality is adequate (which requires that state-of-theart equipment is used and adequate imaging protocols are applied) and patients are appropriately selected, coronary CTA is considered clinically useful in a number of welldefined situations (1-3). Such situations include patients presenting with acute chest pain at an intermediate likelihood of coronary artery disease, with an absence of electrocardiographic (ECG) changes and normal troponin values, or patients with stable chest pain at intermediate likelihood of coronary artery disease, but with equivocal stress test results. In numerous trials and meta-analyses, it has been shown that after appropriate patient selection and with sufficient experience, coronary CTA has a high sensitivity to detect coronary artery stenoses (4 -11). Consequently, in most published studies, the negative predictive value approaches 100%: if a coronary CTA study shows coronary arteries without plaque or stenoses, the false-negative rate is very low. See page 1072On the other hand, there are obvious drawbacks to coronary CTA. It cannot be reliably performed in all patients, and its somewhat limited spatial resolution makes it difficult to accurately assess stenosis degree (12-15). Overestimation of stenosis degree is not uncommon, and false-positive findings do occur, especially if image quality is not optimal. In addition, coronary CTA is an anatomic imaging method and as such shares the limitations of invasive angiography: when a stenosis is seen, it is still uncertain whether this specific lesion causes ischemia (16 -19)-usually considered a prerequisite to justify revascularization.Contrast-enhanced computed tomography (CT) imaging of the heart shows not only the coronary arteries, but also the myocardium. It has been shown that chronic hypoperfusion can easily be seen by CT, for example, in patients after myocardial infarction (20,21). Early data suggest that CT may also be able to detect stress-induced perfusion defects (22,23), and in this issue of the Journal, Blankstein et al. (24) present the first series of patients studied by adenosine-induced stress myocardial perfusion imaging using contrast-enhanced dual-source CT. In fact, their examination protocol was comprehensive and approached what some may be referring to as a "1-stop shop." Thirty-three patients who had a nuclear stress test and underwent invasive coronary angiography were studied by CT. The scan protocol consisted of an initial contrast-enhanced scan acquired during adenosine infusion, a second contrastenhanced scan acquired at rest, and a third scan performed without additional contrast. The initial adenosine stress contrast-enhanced scan served to visualize the coronary arteries and identify coronary artery stenose...

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Indications and reimbursement of cardiac computed tomography angiography: History, present and future perspectives

Cited by 7 publications

References 11 publications

Seismocardiography-Based Cardiac Computed Tomography Gating Using Patient-Specific Template Identification and Detection

Seismocardiography-Based Cardiac Computed Tomography Gating Using Patient-Specific Template Identification and Detection

Applications of carbon dots on tumour theranostics

Stress Computed Tomography Myocardial Perfusion

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