Journal of Cardiovascular Computed Tomography
Volume 3, Issue 3 , Pages 190-204 , May 2009

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

Received 19 March 2009 ,Accepted 24 March 2009.

References 

  1. Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, et al. American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48:1475–1497
  2. Budoff MJ, Cohen MC, Garcia MJ, Hodgson JM, Hundley WG, Lima AC, et al. ACC/AHA clinical competence statement on cardiac imaging with computed tomography and magnetic resonance: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence (ACC/AHA Committee on CV Tomography). J Am Coll Cardiol. 2005;46:383–402
  3. Rubin GD, Bluemke DA, Duerinckx AJ, Flamm SD, Grist TM, Jacobs JE, et al. ACR Committee on Cardiac Imaging. Practice guideline for the performance and interpretation of cardiac computed tomography (CT). (Res. 10, 16g, 17, 34, 35, 36–2006). In: Practice guidelines and technical standards. Reston, VA: American College of Radiology; 2008;p. 421–430
  4. Valentin J. Pregnancy and medical radiation: ICRP publication 84. Ann ICRP. 2000;30:1–39
  5. Webb JA, Thomsen HS, Morcos SK. Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol. 2005;15:1234–1240
  6. Greenberger P, Patterson R. Prednisone-diphenhydramine regimen prior to use of radiographic contrast media. J Allergy Clinical Immunol. 1979;63:295
  7. licker BM , Cypel YS, Weinreb JC. IV contrast administration for CT: a survey of practices for the screening and prevention of contrast nephropathy. AJR Am J Roentgenol. 2006;186:1651–1658
  8. Lee JK, Warshauer DM, Bush WH, McClennan BL, Choyke PL. Determination of serum creatinine level before intravenous administration of iodinated contrast medium: a survey. Invest Radiol. 1995;30:700–705
  9. Briguori C, Airoldi F, D'Andrea D, Bonizzoni E, Morici N, Focaccio A, et al. Renal insufficiency following contrast media administration trial (REMEDIAL): a randomized comparison of 3 preventive strategies. Circulation. 2007;115:1211–1217
  10. Briguori C, Columbo A, Violante A, Balestrieri P, Manganelli F, Paolo Elia P, et al. Standard vs double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity. Eur Heart J. 2004;25:206–211
  11. Lee PT, Chou KJ, Liu CP, Mar GY, Chen CL, Hsu CY, et al. Renal protection for coronary angiography in advanced renal failure patients by prophylactic hemodialysis: a randomized controlled trial. J Am Coll Cardiol. 2007;50:1015–1020
  12. Marenzi G, Assanelli E, Marana I, Lauri G, Campodonico J, Grazi M, et al. N-acetylcysteine and contrast-induced nephropathy in primary angioplasty. N Engl J Med. 2006;354:2773–2782
  13. Barrett BJ, Katzberg RW, Thomsen HS, Chen N, Sahani D, Soulez G, et al. Contrast-induced nephropathy in patients with chronic kidney disease undergoing computed tomography: a double-blind comparison of iodixanol and iopamidol. Invest Radiol. 2006;41:815–821
  14. El-Hajjar M, Bashir I, Khan M, Min J, Torosoff M, DeLago A. Incidence of contrast-induced nephropathy in patients with chronic renal insufficiency undergoing multidetector computed tomographic angiography treated with preventive measures. Am J Cardiol. 2008;102:353–356
  15. Ahuja TS, Niaz N, Agraharkar M. Contrast-induced nephrotoxicity in renal allograft recipients. Clin Nephrol. 2000;54:11–14
  16. Poletti PA, Saudan P, Platon A, Mermillod B, Sautter AM, Vermeulen B, et al. N-acetylcysteine and emergency CT: use of serum creatinine and cystatin C as markers of radiocontrast nephrotoxicity. AJR Am J Roentgenol. 2007;189:687–692
  17. Schmidt P, Pang D, Nykamp D, Knowlton G, Jia H. N-acetylcysteine and sodium bicarbonate versus n-acetylcysteine and standard hydration for the prevention of radiocontrast-induced nephropathy following coronary angiography. Ann Pharmacother. 2007;41:46–50
  18. Solomon R. Contrast media nephropathy: how to diagnose and how to prevent?. Nephrol Dial Transplant. 2007;22:1812–1815
  19. Zagler A, Azadpour M, Mercado C, Hennekens CH. N-acetylcysteine and contrast-induced nephropathy: a meta-analysis of 13 randomized trials. Am Heart J. 2006;151:140–145
  20. Brodoefel H, Reimann A, Heuschmid M, Küttner A, Beck T, Burgstahler C, et al. Non-invasive coronary angiography with 16-slice spiral computed tomography: image quality in patients with high heart rates. Eur Radiol. 2006;16:1434–1441
  21. Cademartiri F, Mollet NR, Runza G, Belgrano M, Malagutti P, Meijboom BW, et al. Diagnostic accuracy of multislice computed tomography coronary angiography is improved at low heart rates. Int J Cardiovasc Imaging. 2006;22:101–105
  22. Hoffmann MH, Shi H, Manzke R, Schmid FT, De Vries L, Grass M, et al. Noninvasive coronary angiography with 16-detector row CT: effect of heart rate. Radiology. 2005;234:86–97
  23. Le Jemtel TH, Padeletti M, Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol. 2007;49:171–182
  24. Dewey M, Hoffmann H, Hamm B. Multislice CT coronary angiography: effect of sublingual nitroglycerine on the diameter of coronary arteries. ROFO Fortschr Geb Rontgenstr Nuklearmed. 2006;178:600–604
  25. Decramer I, Vanhoenacker PK, Sarno G, Van Hoe L, Bladt O, Wijns W, et al. Effects of sublingual nitroglycerin on coronary lumen diameter and number of visualized septal branches on 64-MDCT angiography. AJR Am J Roentgenol. 2008;190:219–225
  26. Wang G, Vannier MW. Spatial variation of section sensitivity profile in spiral computed tomography. Med Phys. 1994;21:1491–1497
  27. Ohnesorge B, Flohr T, Becker C, Kopp AF, Schoepf UJ, Baum U, et al. Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology. 2000;217:564–571
  28. Halliburton SS, Abbara S. Practical tips and tricks in cardiovascular computed tomography: patient preparation for optimization of cardiovascular CT data acquisition. J Cardiovasc Comput Tomogr. 2007;1:62–65
  29. Bae KT, Tran HQ, Heiken JP. Multiphasic injection method for uniform prolonged vascular enhancement at CT angiography: pharmacokinetic analysis and experimental porcine model. Radiology. 2000;216:872–880
  30. Fleischmann D, Rubin GD, Bankier AA, Hittmair K. Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography. Radiology. 2000;214:363–371
  31. Haage P, Schmitz-Rode T, Hubner D, Piroth W, Gunther RW. Reduction of contrast material dose and artifacts by a saline flush using a double power injector in helical CT of the thorax. AJR Am J Roentgenol. 2000;174:1049–1053
  32. Hopper KD, Mosher TJ, Kasales CJ, TenHave TR, Tully DA, Weaver JS. Thoracic spiral CT: delivery of contrast material pushed with injectable saline solution in a power injector. Radiology. 1997;205:269–271
  33. Segal AJ, Ellis JH, Baumgartner BR, Choyke PL, Cohan RH, Costouros NG, et al. ACR Committee on Drugs and Contrast Media. Practice guideline for the use of intravascular contrast media. (Res. 38 – 2007). In: Practice guidelines and technical standards. Reston, VA: American College of Radiology; 2008;p. 73–78
  34. Segal AJ, Ellis JH, Baumgartner BR, Choyke PL, Cohan RH, Cohen M, et al. ACR Committee on Drugs and Contrast Media: Manual on contrast media. Version 6 Reston, VA: American College of Radiology; 2008;
  35. Brenner DJ, Hall EJ. Computed tomography: an increasing source of radiation exposure. New Engl J Med. 2007;357:2277–2284
  36. Overbeek FJ, Pauwels EK, Bloem JL, Camps JA, Geleijns J, Broerse JJ. Somatic effects in nuclear medicine and radiology. Appl Radiat Isot. 1999;50:63–72
  37. Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A. 2003;100:13761–13766
  38. Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation; Nuclear and Radiation Studies Board . Division on Earth and Life Studies, National Research Council of the National Academies: Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006;
  39. Don S. Radiosensitivity of children: potential for overexposure in CR and DR and magnitude of doses in ordinary radiographic examinations. Ped Radiol. 2004;34(Suppl 3):S167–S172
  40. Nickoloff EL, Alderson PO. A comparative study of thoracic radiation doses from 64-slice cardiac CT. Br J Radiol. 2007;80:537–544
  41. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA. 2007;298:317–323
  42. Rybicki FJ, Otero HJ, Steigner ML, Vorobiof G, Nallamshetty L, Mitsouras D, et al. Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging. 2008;24:535–546
  43. Rehani MM, Bongartz G, Kalender W, Golding SJ, Gordon L, Murakami T, et al. Managing patient dose in computed tomography. Ann ICRP. 2000;30:7–45
  44. Hausleiter J, Meyer T, Hadamitzky M, Huber E, Zankl M, Martinoff S, et al. Radiation dose estimates from cardiac multislice computed tomography in daily practice: impact of different scanning protocols on effective dose estimates. Circulation. 2006;113:1305–1310
  45. Siegel MJ, Schmidt B, Bradley D, Suess C, Hildebolt C. Radiation dose and image quality in pediatric CT: effect of technical factors and phantom size and shape. Radiology. 2004;233:515–522
  46. Hermann F, Martinoff S, Meyer T, Hadamitzky M, Jiang C, Hendrich E, et al. Reduction of radiation dose estimates in cardiac 64-slice CT angiography in patients after coronary artery bypass graft surgery. Invest Radiol. 2008;43:253–260
  47. Shuman WP, Branch KR, May JM, Mitsumori LM, Lockhart DW, Dubinsky TJ, et al. Prospective versus retrospective ECG gating for 64-detector CT of the coronary arteries: comparison of image quality and patient radiation dose. Radiology. 2008;248:431–437
  48. Husmann L, Valenta I, Gaemperli O, Adda O, Treyer V, Wyss CA, et al. Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J. 2008;29:191–197
  49. Scheffel H, Alkadhi H, Leschka S, Plass A, Desbiolles L, Guber I, et al. Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart. 2008;94:1132–1137
  50. Geleijns J, Salvado Artells M, Veldkamp WJ, Lopez Tortosa M, Calzado Cantera A. Quantitative assessment of selective in-plane shielding of tissues in computed tomography through evaluation of absorbed dose and image quality. Eur Radiol. 2006;16:2334–2340
  51. Donadieu J, Roudier C, Saguintaah M, Maccia C, Chiron R. Estimation of the radiation dose from thoracic CT scans in a cystic fibrosis population. Chest. 2007;132:1233–1238
  52. Bae KT. Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology. 2003;227:809–816
  53. McCollough C, Cody D, Edyvean S, Geise R, Gould B, Keat N, et al. The Measurement, reporting, and management of radiation dose in CT. College Park, MD: American Association of Physicists in Medicine; 2008;AAPM Report No. 96
  54. Hunold P, Vogt FM, Schmermund A, Debatin JF, Kerkhoff G, Budde T, et al. Radiation exposure during cardiac CT: effective doses at multi-detector row CT and electron-beam CT. Radiology. 2003;226:145–152
  55. Pundziute G, Schuijf JD, Jukema JW, Lamb HJ, de Roos A, van der Wall EE, et al. Impact of coronary calcium score on diagnostic accuracy of multislice computed tomography coronary angiography for detection of coronary artery disease. J Nucl Cardiol. 2007;14:36–43
  56. Cordeiro MA, Miller JM, Schmidt A, Lardo AC, Rosen BD, Bush DE, et al. Non-invasive half millimetre 32 detector row computed tomography angiography accurately excludes significant stenoses in patients with advanced coronary artery disease and high calcium scores. Heart. 2006;92:589–597
  57. Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation. 1995;92:2157–2162
  58. Oncel D, Oncel G, Tastan A. Effectiveness of dual-source CT coronary angiography for the evaluation of coronary artery disease in patients with atrial fibrillation: initial experience. Radiology. 2007;245:703–711
  59. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, et al. Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. Eur Radiol. 2006;16:2739–2747
  60. Cademartiri F, Runza G, Mollet NR, Luccichent G, Belgrano M, Somers P, et al. Influence of increasing convolution kernel filtering on plaque imaging with multislice CT using an ex-vivo model of coronary angiography. Radiol Med (Torino). 2005;110:234–240
  61. Birnbaum BA, Hindman N, Lee J, Babb JS. Multi-detector row CT attenuation measurements: Assessment of intra- and interscanner variability with an anthropomorphic body CT phantom. Radiology. 2007;242:109–119
  62. Dewey M, Teige F, Rutsch W, Schink T, Hamm B. CT coronary angiography: influence of different cardiac reconstruction intervals on image quality and diagnostic accuracy. Eur J Radiol. 2008;67:92–99
  63. Herzog C, Arning-Erb M, Zangos S, Eichler K, Hammerstingl R, Dogan S, et al. Multi-detector row CT coronary angiography: influence of reconstruction technique and heart rate on image quality. Radiology. 2006;238:75–86
  64. Husmann L, Leschka S, Desbiolles L, Schepis T, Gaemperli O, Seifert B, et al. Coronary artery motion and cardiac phases: dependency on heart rate and implications for CT image reconstruction. Radiology. 2007;245:567–576
  65. Leschka S, Wildermuth S, Boehm T, Desbiolles L, Husmann L, Plass A, et al. Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology. 2006;241:378–385
  66. Vembar M, Walker MJ, Johnson PC. Cardiac imaging using multislice computed tomography scanners: technical considerations. Coron Artery Dis. 2006;17:115–123
  67. Wintersperger BJ, Nikolaou K, von Ziegler F, Johnson T, Rist C, Leber A, et al. Image quality, motion artifacts, and reconstruction timing of 64-slice coronary computed tomography angiography with 0.33-second rotation speed. Invest Radiol. 2006;41:436–442
  68. Nagatani Y, Takahashi M, Takazakura R, Nitta N, Murata K, Ushio N, et al. Multidetector-row computed tomography coronary angiography: optimization of image reconstruction phase according to the heart rate. Circ J. 2007;71:112–121
  69. Seifarth H, Wienbeck S, Püsken M, Juergens KU, Maintz D, Vahlhaus C, et al. Optimal systolic and diastolic reconstruction windows for coronary CT angiography using dual-source CT. AJR Am J Roentgenol. 2007;189:1317–1323
  70. Leschka S, Husmann L, Desboilles LM, Gaemperli O, Schepis T, Koepfli P, et al. Kaufmann PA Alkadhi H: Optimal image reconstruction intervals for non-invasive coronary angiography with 64-slice CT. Eur Radiol. 2006;16:1964–1972
  71. Dewey M, Teige F, Laule M, Hamm B. Influence of heart rate on diagnostic accuracy and image quality of 16-slice CT coronary angiography: comparison of multisegment and halfscan reconstruction approaches. Eur Radiol. 2007;17:2829–2837
  72. Weininger M, Ritter C, Beer M, Hahn D, Beissert M. Evaluation of the optimal image reconstruction interval for coronary artery imaging using 64-slice computed tomography. Acta Radiol. 2007;48:620–627
  73. Frydrychowicz A, Pache G, Saueressig U, Foll D, Kotter E, Langer M, et al. Comparison of reconstruction intervals in routine ECG-pulsed 64-row MSCT coronary angiography in frequency controlled patients. Cardiovasc Intervent Radiol. 2007;30:79–84
  74. Herzog C, Nguyen SA, Savino G, Zwerner PL, Doll J, Nielsen CD, et al. Does two segment image reconstruction at 64-section CT coronary angiography improve image quality and diagnostic accuracy?. Radiology. 2007;244:121–129
  75. Cademartiri F, Mollet NR, Runza G, Baks T, Midiri M, McFadden EP, et al. Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing. AJR Am J Roentgenol. 2006;186:634–638

 Conflict of interest: The authors report no conflicts of interest.

 The Guidelines Committee consisted of Gilbert L. Raff, MD (Co-Chair), Wm. Guy Weigold, MD (Co-Chair), J. Jeffrey Carr, MD, Mario J. Garcia, MD, Jeffrey C. Hellinger, MD, and Michael Poon, MD.

PII: S1934-5925(09)00145-2

doi: 10.1016/j.jcct.2009.03.004

Journal of Cardiovascular Computed Tomography
Volume 3, Issue 3 , Pages 190-204 , May 2009

Article Tools