Canadian Association of Radiologists: Consensus Guidelines and Standards for Cardiac CT

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 .…”

Systematic Review of Guidelines on Imaging of Asymptomatic Coronary Artery Disease

“…Generally, risk was determined by Framingham risk equations for estimation of a 10-year risk for coronary events (fatal and nonfatal) using the categories Ͻ10%, 10% to 20%, and Ͼ20% for, respectively, low, intermediate, and high risk. However, 2 guidelines (CAR [18] and CCS2 [19]) did not specify any criteria for low, intermediate, and high risk. None advocated a universal screening approach or screening based on an age criterion alone.…”

“…Fourteen guidelines (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) relevant to testing of asymptomatic CAD were eligible for full data extraction ( Fig. 1).…”

“…In the remaining 6 guidelines (ACCF1 [15], AHA2 [8], National Cholesterol Education Program [NCEP] [16,17], CAR [18], CCS2 [19], and ACCF2 [20]), testing was only advocated for patients with an a priori elevated risk level based on absolute CAD risk or multiple risk factors. Generally, risk was determined by Framingham risk equations for estimation of a 10-year risk for coronary events (fatal and nonfatal) using the categories Ͻ10%, 10% to 20%, and Ͼ20% for, respectively, low, intermediate, and high risk.…”

“…The majority of guidelines, except for the Canadian Cardiovascular Society (CCS) 2 guideline (19), were based on a comprehensive review including study quality assessment. Apart from the Canadian Association of Radiologists (CAR) (18) and CCS2 (19) guidelines, a grading system for assigning the level of evidence was used. Evaluation of cost effectiveness of recommended tests was explicitly done in only 2 guidelines, the U.S. Preventive Services Task Force (USPSTF) 1 (11) and ACCF1 (15) guidelines, by reviewing decision modeling studies on exercise tolerance testing (23)(24)(25) and CT calcium scoring (26,27), respectively.…”