SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the Society of Cardiovascular Computed Tomography Guidelines Committee

Abbara, Suhny; Blanke, Philipp; Maroules, Christopher D.; Cheezum, Michael K.; Choi, Andrew D.; Han, Bo; Marwan, Mohamed; Naoum, Chris; Nørgaard, Bjarne Linde; Rubinshtein, Ronen; Schoenhagen, Paul; Villines, Todd C.; Leipsic, Jonathon

doi:10.1016/j.jcct.2016.10.002

Cited by 773 publications

(449 citation statements)

References 89 publications

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“…Routine CCTA, using dual-source scanners (Somatom Definition Flash or Force, Siemens, Forchheim, Germany, or Revolution CT, GE HealthCare, Little Chalfont, UK) will be performed according to societal guidelines [14]. Briefly, pretreatment with β-blockers or ivabradine will be administered if considered necessary, targeting a heart rate of <60 beats/min.…”

Section: Methodsmentioning

confidence: 99%

“…However, CCTA has only modest accuracy for the quantification of stenosis severity, further hampered by high levels of coronary calcium, which leads to difficulties in estimating stenosis severity because of blooming artifacts obscuring the vessel lumen and resulting in reduced diagnostic specificity [11-13]. Current European Society of Cardiology (ESC) guidelines do not recommend CCTA for patients with severe coronary calcium (Agatston score [AS] >399) [1] and the Society of Cardiovascular Computed Tomography (SCCT) guidelines state that it is controversial to proceed to CCTA in patients with a high calcium score [14]. …”

Section: Introductionmentioning

confidence: 99%

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Functional and Anatomical Testing in Intermediate Risk Chest Pain Patients with a High Coronary Calcium Score: Rationale and Design of the FACC Study

Øvrehus¹,

Veien²,

Lambrechtsen³

et al. 2019

Cardiology

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Current guidelines do not recommend coronary computed tomography angiography (CCTA) in patients with high levels of coronary calcium, as severe calcification leads to difficulties in estimating stenosis severity due to blooming artifacts obscuring the vessel lumen. Whether the CCTA-derived fractional flow reserve (FFR_CT) improves the diagnostic performance of CCTA in patients with high levels of coronary calcification has not been sufficiently evaluated. We hypothesize that a noninvasive diagnostic strategy using FFR_CT will perform comparably to an invasive diagnostic strategy in the detection of hemodynamically significant coronary artery disease (CAD) in clinical stable chest pain patients with high levels of coronary calcium. In this prospective, blinded, multicenter study, patients with suspected stable CAD referred for CCTA and demonstrating an Agatston score >399 will be included. Patients accepting inclusion will, in addition to CCTA, undergo invasive coronary angiography (ICA) and invasive FFR measurement. FFR_CT analyses are performed by an external core laboratory blinded to any patient data, and the FFR_CT results are blinded to all participating study sites. The primary objective is to evaluate whether FFR_CT can identify patients with and without hemodynamically significant CAD, when ICA with FFR is the reference standard. A negative study result would question the clinical usefulness of FFR_CT in patients with high levels of coronary calcium. A positive study result, however, would imply a reduction in the number of patients referred for coronary catheterization and, at the same time, increase the proportion of patients with hemodynamically significant CAD at the subsequent invasive examination.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional and Anatomical Testing in Intermediate Risk Chest Pain Patients with a High Coronary Calcium Score: Rationale and Design of the FACC Study

Øvrehus¹,

Veien²,

Lambrechtsen³

et al. 2019

Cardiology

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show abstract

“…13,14 All datasets underwent blinded analysis at a single core laboratory. Coronary atherosclerosis evaluation by CTA was performed on multiplanar and cross-sectional images by Level III-experienced readers masked to clinical results using semi-automated plaque analysis software (QAngioCT Research Edition v2·1·9·1; Medis Medical Imaging Systems, Leiden, the Netherlands) with manual correction.…”

Section: Coronary Computed Tomography Angiographymentioning

confidence: 99%

Impact of Non-obstructive left main disease on the progression of coronary artery disease: A PARADIGM substudy

Weir‐McCall

Blanke

Sellers

et al. 2018

Journal of Cardiovascular Computed Tomography

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Background: The aim of the study is examine the impact of non-obstructive (< 50%stenosis) left main (LM) disease on the natural history of coronary artery disease using serial coronary computed tomography angiography (CTA). Methods: CTAs from the PARADIGM (Progression of atherosclerotic plaque determined by computed tomographic angiography imaging) study, a prospective multinational registry of patients who underwent serial CTA at a ≥2 year interval were analyzed. Those without evidence of CAD on their baseline scan were excluded, as were those with obstructive left main disease. Coronary artery vessels and their branches underwent quantification of: plaque volume and composition; diameter stenosis; presence of high-risk plaque. Results: Of 944 (62 ± 9 years, 60% male) who had evidence of CAD at baseline, 444 (47%) had LM disease. Those with LM disease had a higher baseline plaque volume (194.8 ± 221mm3 versus 72.9 ± 84.3mm3, p < 0.001) and a higher prevalence of high-risk plaque (17.5% versus 13%, p < 0.001) than those without LM disease. On multivariable general linear model, patients with LM disease had greater annual rates of progression of total (26.5 ± 31.4mm3/yr versus 14.9 ± 20.1mm3/yr, p < 0.001) and calcified plaque volume (17 ± 24mm3/yr versus 7 ± 11mm3/yr, p < 0.001), with no difference in fibrous, fibrofatty or necrotic core plaque components. Conclusion: The presence of non-obstructive LM disease is associated with greater rates of plaque progression and a higher prevalence of high-risk plaque throughout the entire coronary artery tree compared to CAD without LM involvement. Our data suggests that non-obstructive LM disease may be a marker for an aggressive phenotype of CAD that may benefit from more intensive treatment strategies.

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“…CT acquisition and analysis are standardized, but undergo incremental changes based on technical developments [79]. Using a latest generation 320-row Area Detector CT (320-ADCT), Kawaguchi et al analyze the potential impact of full versus half reconstruction technique, standard versus reduced tube current, and advanced patient motion correction on radiation exposure for coronary CTA.…”

Section: Computed Tomographymentioning

confidence: 99%

Cardiovascular imaging 2017 in the International Journal of Cardiovascular Imaging

Reiber

Alaiti

Bezerra

et al. 2018

Int J Cardiovasc Imaging

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SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the Society of Cardiovascular Computed Tomography Guidelines Committee

Cited by 773 publications

References 89 publications

Functional and Anatomical Testing in Intermediate Risk Chest Pain Patients with a High Coronary Calcium Score: Rationale and Design of the FACC Study

Functional and Anatomical Testing in Intermediate Risk Chest Pain Patients with a High Coronary Calcium Score: Rationale and Design of the FACC Study

Impact of Non-obstructive left main disease on the progression of coronary artery disease: A PARADIGM substudy

Cardiovascular imaging 2017 in the International Journal of Cardiovascular Imaging

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