Korean Guidelines for the Appropriate Use of Cardiac CT

Abstract

The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

Current utilization of cardiac computed tomography in mainland China: A national survey

“…Second, several of the CCTA indications used by these hospitals were considered generally inappropriate by guidelines. For example, 95.4% of respondents stated that they performed CCTA in clinically healthy people, which was conflict to the latest criteria [13][14][15][16][17][18] . The common view of appropriateness criteria for cardiac CT is to detect asymptomatic coronary artery disease with intermediate pretest likelihood and suspected coronary anomalies, though few experts deemed that CCTA could be used as a screening test 19 , 20 , 21 .…”

Breast Arterial Calcification is Associated with the Progression of Coronary Atherosclerosis in Asymptomatic Women: A Preliminary Retrospective Cohort Study

“…Specifically, only 126 women of the 2,100 women in the BBC registry underwent repeated CCTA examinations. Although we were able to populate the BBC registry, because CCTA has been used as a screening tool through a self-referral mechanism in Korea, CCTA is not currently indicated in asymptomatic individuals 7 . Thus, it is not surprising that only a small number of women from the BBC registry underwent repeated CCTA examinations.…”

“…A total of 2,100 consecutive asymptomatic women aged ≥40 years who underwent digital mammography, dual-energy X-ray absorptiometry, and coronary computed tomography angiography (CCTA) as part of a general health evaluation at the Health Promotion Center, Seoul National University Bundang Hospital, between 2011 and 2013 were included in the BBC study. As we previously described, although most Korean health check-up centers are currently trying to curb the use of CCTA in asymptomatic individuals 7 , Korean individuals have been able to undergo CCTA through a self-referral mechanism. The design, characteristics, and primary findings of the BBC study have previously been described 6 .…”

Methodology for Developing Evidence-Based Clinical Imaging Guidelines: Joint Recommendations by Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

“…In Korea, the need for radiological guidelines led to the development of ‘the CT Examination and Repeat CT Examination Guideline’ by collaboration of Health Insurance Review & Assessment Service and Korean Society of Radiology (KSR) (9), ‘the Guideline for Diagnosis and Management of Hepatocellular Carcinoma’ by Korean Liver Cancer Study Group (10), ‘the Guideline for Ultrasonographic Diagnosis and Image-Based Management of Thyroid Nodules’ by Korean Society of Thyroid Radiology (11), ‘Korean Guideline for Interventional Recanalization of Lower Extremity Arteries’ by collaboration of multi-disciplinary societies including Korean Society of Interventional Radiology (12), and ‘the Guidelines for Appropriate Use of Cardiac CT in Heart Disease’ by the KSR, Korean Society of Cardiology, and National Strategic Coordinating Center of Clinical Research (1314). However, as there are still no CIGs that comprehensively support physicians to prescribe diagnostic and interventional radiologic procedures which are appropriately suited to the situation in Korea, the need for a Korean version of evidence-based clinical medical radiology guidelines has become paramount.…”