The aim of the study was to analyse the temporal and geographic distribution of radiologists, computed tomography and magnetic resonance scanners in Croatia. In this observational study we estimated radiologists’ number per 100,000 population for 1997, 2006, and 2017 and compared private and public CT and MR scanners between 2011 and 2018. We analyzed the availability of radiologists and scanners, and the relationship between the radiological workforce and economic strength among counties. The workforce increased significantly from 1997 to 2017 and was associated with economic strength categories in 2017. In 2018, there were more CT scanners in the public sector, while MR scanners were distributed evenly. In 2011, there was similar distribution of CT and MR between sectors, while in 2018 there were significantly more public CT scanners. Counties with a medical school had significantly more radiologists and MR scanners. The high-to-low ratios per CT and MR were 11 and 8.2, suggesting inequality of health care. Croatia significantly increased its radiological workforce; however, cross-county inequality remained. Counties with higher economic strength and medical schools have better availability of radiologists and equipment. To ensure the sustainable activity of the health care system, a precise estimate of supply and demand of radiology services is needed.

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AimTo evaluate how coronary computed tomography-angiography (CCTA) altered the management and treatment of patients with suspected coronary artery disease (CAD).MethodsDuring 2009, we studied 792 consecutive patients with suspected CAD. CCTA was performed in all patients using a 64-slice dual-source CT scanner and standard scanning protocols.ResultsAfter CCTA, obstructive CAD was excluded in 666 patients. During the 12-month clinical follow-up, 98.6% of these patients were free of major adverse cardiac events. Also, the indication for cardiac catheterization (CC) was revoked in 77.2% of patients. It was also revoked in all patients with low Morise pre-test risk, 80.7% with intermediate risk, and 72.6% with high risk. Medical therapy was changed in 54.7% of patients with confirmed CAD.ConclusionCCTA can reliably exclude significant CAD not only in patients with low and moderate risk, but also in those with high risk. It can also reliably replace CC in the majority of elective patients regardless of risk stratification. It can also be useful in risk reclassification and optimization of medical therapy in patients with CAD.

The aim of the study was to quantify the total coronary atherosclerotic burden in patients with suspected coronary artery disease (CAD) defined by coronary computed tomography adapted Leaman score (CT-LeSc) and to estimate its cut-off level for high coronary atherosclerotic burden. We enrolled 434 consecutive patients referred to coronary computed tomography angiography, of which 261 patients fulfilled the study inclusion criteria. Demographic and clinical characteristics, as well as CAD risk factors were obtained. CAD pre-test probabilities were estimated by the Diamond-Forrester model and Morise score. The coronary atherosclerotic burden was estimated using CT-LeSc. As a cut-off for a high coronary atherosclerotic burden, we used 3rd tercile (Tc3) (CT-LeSc ≥ 5.52). We evaluated the association of clinical characteristics and risk factors with Tc3 in univariate and multivariate analysis. There were 60.9% males and 39.1% females, 81% of patients had above-normal weight, 68.2% hypertension, 54.0% dyslipidemia, 15.3% diabetes mellitus, 12.3% positive smoking history and 11.9% had a family history of CAD. According to the Diamond-Forrester model and Morise score the majority of patients had intermediate risk, 59.7 and 52.8%, followed by the high-risk group, 36.0 and 34.4%, respectively. Age, dyslipidemia, hypertension and pre-test risk scores in the univariate analysis significantly predicted Tc3. In the multivariate analysis, male sex (p = 0.004), dyslipidemia (p = 0.002) and coronary calcium score (< 0.001) were identified as predictors of Tc3. CT-LeSc quantified the total coronary atherosclerotic burden and showed an association of risk factors and pre-test probabilities with Tc3.