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Coronary CT Angiography

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1. Early detection of lung cancer using ultra-low-dose computed tomography in coronary CT angiography scans among patients with suspected coronary heart disease. (Abstract)

Early detection of lung cancer using ultra-low-dose computed tomography in coronary CT angiography scans among patients with suspected coronary heart disease. To assess whether an additional chest ultra-low-dose CT scan to the coronary CT angiography protocol can be used for lung cancer screening among patients with suspected coronary artery disease.175 patients underwent coronary CT angiography for assessment of coronary artery disease, additionally undergoing ultra-low-dose CT screening (...) cancer might be detected using additional ultra-low-dose protocols in coronary CT angiography scans among patients with suspected coronary artery disease.Copyright © 2017 Elsevier B.V. All rights reserved.

2017 Lung Cancer

2. Quantitative analysis of epicardial fat volume: effects of scanning protocol and reproducibility of measurements in non-contrast cardiac CT vs. coronary CT angiography Full Text available with Trip Pro

Quantitative analysis of epicardial fat volume: effects of scanning protocol and reproducibility of measurements in non-contrast cardiac CT vs. coronary CT angiography Several studies have focused on the role of epicardial fat in the pathogenesis of cardiovascular disease (CVD). The main purpose of the study was to evaluate a computerized method for the quantitative analysis of epicardial fat volume (EFV) by non-contrast cardiac CT (NCT) for coronary calcium scan and coronary CT angiography (...) for 6 and 3 SA slices respectively. ICC values >0.99 were obtained in all cases. The right ventricular EFV was 67.23±31.4 and 57.41±34.3 cc for NCT and coronary CTA respectively; the corresponding values for left ventricular EFV were 38.01±19.1 and 35.27±25.9 cc.Both NCT and coronary CTA can be used with low intra- and inter-observer variability for computer-assisted measurements of EFV. Cardiac CT may allow a fast and reliable computation of EFV in clinical setting.

2017 Quantitative imaging in medicine and surgery

3. Coronary CT in Australia has high positive predictive value unaffected by site volume: An analysis of 510 positive CTCA scans with invasive angiographic correlation Full Text available with Trip Pro

Coronary CT in Australia has high positive predictive value unaffected by site volume: An analysis of 510 positive CTCA scans with invasive angiographic correlation It was hypothesized that the accuracy of coronary CT angiography would be affected by case volume of the referring sites.The positive predictive value (PPV) of CTCA performed at a tertiary hospital specialising in cardiothoracic medicine and services with lower case-volumes were calculated. The tertiary hospital used as the high (...) case-volume reference centre was The Prince Charles Hospital, which performed >1500 CTCA scans per annum over the study period. The low case-volume services used in the study were suburban radiology services, each with <500 cases per year. The PPV of positive CTCA at the reference site was compared to the pooled PPV of all other sites as a combined cohort, using invasive angiography as the reference standard. 512 scans were included, n = 199 subjects in the reference centre cohort, and n = 311

2018 International journal of cardiology. Heart & vasculature

4. Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients. (Abstract)

Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients. Scanxiety, the anxiety/stress associated with an imaging test, has never been evaluated in relation to coronary CT angiography (Coronary CTA). As it could impact heart rate and thereby affect image quality of Coronary CTA, we aimed to evaluate the prevalence, severity, and impact of scanxiety on quality and interpretability of Coronary CTA.366 consecutive patients were (...) (59.9% men, 57.6 ± 10.7yo) completed the questionnaire. 74.1% (255 patients) reported some scan-related distress, with a mean IES-6 score of 4.1 ± 4.3 (range 0-18). There was no significant difference in terms of age, sex or indications for Coronary CTA between the non-anxious (IES-6 = 0) and the anxious (IES-6>0) patients. There was no significant independent correlation between image quality and IES-6 score (OR = 0.98, p = 0.62), nor between IES-6 score and heart rate variability (effect = -0.005

2018 Journal of cardiovascular computed tomography

5. Prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp with 30mL contrast agent: An intraindividual comparison with sequential scanning at 120 kVp with 60mL contrast agent. (Abstract)

Prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp with 30mL contrast agent: An intraindividual comparison with sequential scanning at 120 kVp with 60mL contrast agent. To investigate image quality, radiation dose, and diagnostic efficiency of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp with 30mL contrast agent intra-individually compared with routine CCTA protocol.One hundred and thirty eight patients with suspected coronary artery (...) disease, body mass index (BMI)≤25kg/m2 and heart rate (HR)≤70 beats per minute (bpm) underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp and 30mL contrast agent (protocol A) and prospectively ECG-triggered sequential scanning at 120 kVp and 60mL contrast medium (protocol B). Objective and subjective image quality, radiation doses, and diagnostic accuracy were evaluated and compared between the two protocols.Higher CT attenuation, higher noise, lower signal-to-noise ratios (SNRs) and lower

2018 European journal of radiology Controlled trial quality: uncertain

6. Evidence Assist - Coronary Computed Tomography Angiography Innovations in Noninvasive Diagnosis of Coronary Artery Disease

Evidence Assist - Coronary Computed Tomography Angiography Innovations in Noninvasive Diagnosis of Coronary Artery Disease Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Evidence Assist: Coronary Computed Tomography Angiography Innovations in Noninvasive Diagnosis of Coronary Artery Disease Health Services Research & Development Evidence Assist: Coronary Computed Tomography Angiography Innovations (...) in Noninvasive Diagnosis of Coronary Artery Disease to the ESP Report RSS feed Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director Recommended Citation: Helfand M, Anderson J, Peterson K, Bourne D. Evidence Assist: Coronary Computed Tomography Angiography Innovations in Noninvasive Diagnosis of Coronary Artery Disease. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service

2019 Veterans Affairs Evidence-based Synthesis Program Reports

7. Clinical Outcomes of Dynamic Computed Tomography Myocardial Perfusion Imaging Combined With Coronary Computed Tomography Angiography Versus Coronary Computed Tomography Angiography-Guided Strategy. (Abstract)

Clinical Outcomes of Dynamic Computed Tomography Myocardial Perfusion Imaging Combined With Coronary Computed Tomography Angiography Versus Coronary Computed Tomography Angiography-Guided Strategy. Dynamic computed tomography (CT) myocardial perfusion imaging (MPI) provides quantitative myocardial blood flow for the precise assessment of myocardial ischemia. However, compared with coronary CT angiography (CCTA), whether this functional imaging modality can reduce invasive coronary angiography (...) angiography within 90 days (48.3% [58/120] versus 30.8% [37/120], P=0.006) and invasive coronary angiography without revascularization (50.0% [29/58] versus 10.8% [4/37], P<0.0001). There were no significant differences regarding the frequency of major adverse cardiac event between the 2 groups at the 3-month, 6-month, and 1-year follow-up.In patients with intermediate pretest probability of coronary artery disease, CT-MPI+CCTA-guided patient management may be preferred over the CCTA-guided strategy

2020 Circulation. Cardiovascular imaging

8. Diagnostic Phase of Calcium Scoring Scan Applied as the Center of Acquisition Window of Coronary Computed Tomography Angiography Improves Image Quality in Minimal Acquisition Window Scan (Target CTA Mode) Using the Second Generation 320-Row CT Full Text available with Trip Pro

Diagnostic Phase of Calcium Scoring Scan Applied as the Center of Acquisition Window of Coronary Computed Tomography Angiography Improves Image Quality in Minimal Acquisition Window Scan (Target CTA Mode) Using the Second Generation 320-Row CT To compare the image quality of coronary computed tomography angiography (CCTA) acquired under two conditions: 75% fixed as the acquisition window center (Group 75%) and the diagnostic phase for calcium scoring scan as the center (CS; Group CS).320-row (...) cardiac CT with a minimal acquisition window (scanned using "Target CTA" mode) was performed on 81 patients. In Group 75% (n = 40), CS was obtained and reconstructed at 75% and the center of the CCTA acquisition window was set at 75%. In Group CS (n = 41), CS was obtained at 75% and the diagnostic phase showing minimal artifacts was applied as the center of the CCTA acquisition window. Image quality was evaluated using a four-point scale (4-excellent) and the mean scores were compared between

2016 The Scientific World Journal

9. Triple-rule-out CT angiography using two axial scans with 16 cm wide-detector for radiation dose reduction. (Abstract)

Triple-rule-out CT angiography using two axial scans with 16 cm wide-detector for radiation dose reduction. To explore the use of two consecutive axial scans in triple-rule-out (TRO) examination on a 16 cm wide-detector CT for radiation dose reduction.Sixty TRO patients were assigned to either study group (Group A, n = 30) or control group (Group B, n = 30). Group A used a two-phasic contrast injection: 25mgI/kg/s for 12 s in 1st and at 3.0 ml/s injection rate for 7 s in 2nd phase (...) . The pulmonary artery, coronary artery and aorta were scanned in succession with two axial scans using smart-coverage technique. Group B used the conventional protocol of scanning pulmonary arteries first in helical, followed by coronary arteries in axial and aorta in helical mode with contrast injection of 25mgI/kg/s for 14 s. All images were reconstructed with 80% ASIR-V. The qualitative and quantitative image assessment and effective dose of the two groups were statistically compared.The demographic data

2018 European radiology Controlled trial quality: uncertain

10. What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care for the Evaluation of Acute Chest Pain? (SRS diagnosis)

-857. 5. Stefanini GG, Windecker S. Can coronary computed tomography angiography replace invasive angiography? coronary computed tomography angiography cannot replace invasive angiography. Circulation. 2015;131:418-425. 6. Agus AM, McKavanagh P, Lusk L, et al. The cost-effectiveness of cardiac computed tomography for patients with stable chest pain. Heart. 2016;102:356-362. 7. Yarmohammadian MH, Rezaei F, Haghshenas A, et al. Overcrowding in emergency departments: a review of strategies to decrease (...) What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care for the Evaluation of Acute Chest Pain? (SRS diagnosis) TAKE-HOME MESSAGE Compared with existing standards of care for the evaluation of acute chest pain, coronary computed tomography (CT) angiography is associated with similar rates of major adverse events, but higher rates of revascularization. What Is the Utility of Coronary Computed Tomography Angiography Compared With Standard of Care

2018 Annals of Emergency Medicine Systematic Review Snapshots

11. Does a normal CT scan within 6?h rule out subarachnoid haemorrhage?

, subarachnoid haemorrhage. Clinical Bottom Line CT scan alone is sensitive enough to rule out subarachnoid haemorrhage in patients presenting with lone acute severe headache, normal level of consciousness, and no neurological features, if performed within 6 h of onset with a third generation CT scanner with thin slices, and reported by a radiologist experienced in reporting CT brain scans. References Perry JJ , Stiell IG , Sivilotti MLA , et al . Sensitivity of computed tomography performed within six hours (...) / OR xanthochromia.mp. OR bilirubin.mp. or exp Bilirubin/) AND (exp Tomography, X-Ray Computed/ or ct scan.mp.) Search Outcome Ovid Medline (1946 to August week 2 2015): 13 papers, 4 of which were relevant to this question. These are presented in the table Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Perry et al, 2011 Canada Patients over 15 years of age presenting with acute non-traumatic headache (maximum intensity within 1 h

2015 BestBETS

12. Chest pain with NonDiagnostic ECG but Diagnostic CT Scan

Chest pain with NonDiagnostic ECG but Diagnostic CT Scan Dr. Smith's ECG Blog: Chest pain with NonDiagnostic ECG but Diagnostic CT Scan Friday, September 27, 2019 An elderly woman presented with chest pain that radiated to the back for several hours. Here is here initial ECG: There is only a nonspecific flat T-wave in aVL. It is essentially normal. The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI) Providers were concerned with aortic dissection, so (...) on Spectral CT: Here is the image using Spectral CT : It is much more obvious with this technique! See more images of this case at Gopal's Spectral CT Blog: With continued symptoms, an elevated troponin, and no other explanation, this is acute MI with ongoing ischemia until proven otherwise. The CT scan confirms no other explanation and also confirms that this is acute Transmural ischemia diagnostic of OMI (Occlusion MI). If the patient were no longer symptomatic, one could conclude that the infarct

2019 Dr Smith's ECG Blog

13. Impact of computed tomography (CT)-derived fractional flow reserve on reader confidence for interpretation of coronary CT angiography. (Abstract)

Impact of computed tomography (CT)-derived fractional flow reserve on reader confidence for interpretation of coronary CT angiography. To assess the impact of computed tomography-derived fractional flow reserve (FFRCT) on reader confidence and reader time for interpretation of coronary computed tomography angiography (CCTA).This IRB-approved, HIPAA-compliant, consent waivered, quality-improvement study included 50 patients (23 women, age 67 ± 12years, body mass index 28.7 ± 5.3 kg/m2). CCTA (...) was acquired on 2nd and 3rd generation dual-source MDCT with use of beta-blockers and nitroglycerin, and FFRCT was calculated (HeartFlow,Redwood City,CA). Two readers with experience level COCATS2 (Core- Cardiology-Training-Symposium) and two with COCATS3 assessed severity of epicardial coronary artery disease (CAD) using CCTA alone and CCTA with FFRCT. Reader confidence for CAD and hemodynamically significant stenosis (HS) was rated on a 4-point Likert-scale (1=high, 2=good, 3=limited, 4=none

2019 European journal of radiology Controlled trial quality: uncertain

14. Dynamic Stress Computed Tomography Perfusion With a Whole-Heart Coverage Scanner in Addition to Coronary Computed Tomography Angiography and Fractional Flow Reserve Computed Tomography Derived. (Abstract)

tomography (CT) scanner as compared with clinically indicated invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR).Recently, new techniques such as dynamic stress computed tomography perfusion (stress-CTP) emerged as potential strategies to combine anatomical and functional evaluation in a one-shot scan. However, previous experiences with this technique were associated with high radiation exposure.Eighty-five consecutive symptomatic patients scheduled for ICA were prospectively (...) Dynamic Stress Computed Tomography Perfusion With a Whole-Heart Coverage Scanner in Addition to Coronary Computed Tomography Angiography and Fractional Flow Reserve Computed Tomography Derived. The aims of the study were to test the diagnostic accuracy of integrated evaluation of dynamic myocardial computed tomography perfusion (CTP) on top of coronary computed tomography angiography (cCTA) plus fractional flow reserve computed tomography derived (FFRCT) by using a whole-heart coverage computed

2019 JACC. Cardiovascular imaging

15. Feasibility of planning coronary artery bypass grafting based only on coronary computed tomography angiography and CT-derived fractional flow reserve: a pilot survey of the surgeons involved in the randomized SYNTAX III Revolution trial. Full Text available with Trip Pro

recommend a heart team approach and assessment of coronary artery disease (CAD) complexity, objectively quantified by the anatomical SYNTAX score. Coronary computed tomography angiography (CCTA) and CT-derived fractional flow reserve (FFRCT) are emerging technologies in the diagnosis of stable CAD. In this study, data from patients with left main or 3-vessel CAD who underwent CABG were evaluated to assess the feasibility of developing a surgical plan based on CCTA integrated with FFRCT. The primary (...) Feasibility of planning coronary artery bypass grafting based only on coronary computed tomography angiography and CT-derived fractional flow reserve: a pilot survey of the surgeons involved in the randomized SYNTAX III Revolution trial. Invasive coronary angiography has been the preferred diagnostic method to guide the decision-making process between coronary artery bypass grafting (CABG) and percutaneous coronary intervention and plan a surgical revascularization procedure. Guidelines

2019 Interactive cardiovascular and thoracic surgery Controlled trial quality: uncertain

16. Diagnostic performance of free-breathing coronary computed tomography angiography without heart rate control using 16-cm z-coverage CT with motion-correction algorithm. (Abstract)

Diagnostic performance of free-breathing coronary computed tomography angiography without heart rate control using 16-cm z-coverage CT with motion-correction algorithm. To evaluate the feasibility of coronary computed tomography angiography (CCTA) in patients with free-breathing using 16-cm z-coverage CT with motion correction algorithm.616 patients underwent CCTA without heart rate control. 325 examinations were performed during breath-holding (group A), and the remaining 291 were performed (...) during free-breathing (group B). The image quality scores were defined as 1 (excellent), 2 (good), 3 (adequate), and 4 (poor). 22 patients in group A and 24 in group B underwent invasive coronary angiography (ICA) after CCTA within two weeks. The image quality score, diagnostic accuracy using ICA as reference, signal-to-noise ratio (SNR), and effective dose (ED) were compared between the two groups.Mean heart rate during scanning was 70.8 ± 13.8 bpm in group A and 70.7 ± 13.2 bpm in group B (P = .950

2019 Journal of cardiovascular computed tomography

17. Accuracy of Calcium Scoring calculated from contrast-enhanced Coronary Computed Tomography Angiography using a dual-layer spectral CT: A comparison of Calcium Scoring from real and virtual non-contrast data. Full Text available with Trip Pro

Accuracy of Calcium Scoring calculated from contrast-enhanced Coronary Computed Tomography Angiography using a dual-layer spectral CT: A comparison of Calcium Scoring from real and virtual non-contrast data. Modern non-invasive evaluation of Coronary Artery Disease (CAD) requires non-contrast low dose Computed Tomography (CT) imaging for determination of Calcium Scoring (CACS) and contrast-enhanced imaging for evaluation of vascular stenosis. Several methods for calculation of CACS from (...) in comparison to standard non-contrast imaging.We consecutively investigated 20 patients referred to Coronary Computed Tomography Angiography (CCTA) with suspicion of CAD using a Dual-Layer spectral CT system (IQon; Philips Healthcare, The Netherlands). CACS was calculated from both, real- and virtual non-contrast images by certified software for medical use. Correlation analyses for real- and virtual non-contrast images and agreement evaluation with Bland-Altman-Plots were performed.Mean patient age

2018 PLoS ONE

18. Risk Reclassification With Coronary Computed Tomography Angiography-Visualized Nonobstructive Coronary Artery Disease According to 2018 American College of Cardiology/American Heart Association Cholesterol Guidelines (from the Coronary Computed Tomography (Abstract)

Risk Reclassification With Coronary Computed Tomography Angiography-Visualized Nonobstructive Coronary Artery Disease According to 2018 American College of Cardiology/American Heart Association Cholesterol Guidelines (from the Coronary Computed Tomography The 2018 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guideline recommends risk enhancers in the borderline-risk and statin recommended/intermediate-risk groups. We determined the risk (...) reclassification by the presence and severity of coronary computed tomography angiography (CCTA)-visualized coronary artery disease (CAD) according to statin eligibility groups. Of 35,281 individuals who underwent CCTA, 1,303 asymptomatic patients (age 59, 65% male) were identified. Patients were categorized as low risk, borderline risk, statin recommended/intermediate risk or statin recommended/high risk according to the guideline. CCTA-visualized CAD was categorized as no CAD, nonobstructive, or obstructive

2019 American Journal of Cardiology

19. Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Ca Full Text available with Trip Pro

Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Ca To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations (...) of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard.We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA

2017 Korean Journal of Radiology

20. The value of Coronary Artery computed Tomography as the first-line anatomical test for stable patients with indications for invasive angiography due to suspected Coronary Artery Disease: CAT-CAD randomized trial. (Abstract)

The value of Coronary Artery computed Tomography as the first-line anatomical test for stable patients with indications for invasive angiography due to suspected Coronary Artery Disease: CAT-CAD randomized trial. The aim of this prospective, randomized trial was to evaluate whether the use of coronary computed tomography angiography (CCTA) as the first-line anatomical test in patients with suspected significant coronary artery disease (CAD) may reduce the number of coronary invasive (...) angiographies (ICA), and expand the use of CCTA in patients currently diagnosed invasively.120 patients (age:60.6 ± 7.9 years, 35% female) with indications to ICA were randomized 1:1 to undergo CCTA versus direct ICA. Outcomes were evaluated during the diagnostic and therapeutic periods.The number of invasively examined patients was reduced by 64.4% in the CCTA group as compared to the direct ICA group (21vs59,p < 0.0001). The number of patients with ICAs not followed by coronary intervention was reduced

2018 Journal of cardiovascular computed tomography Controlled trial quality: uncertain

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