Coronary CT angiography (CCTA) acquisition guidelines defer the performance of coronary
artery calcium (CAC) scanning prior to CCTA to provider and site preferences.
1
According to large-scale registry data, CAC scanning is frequently performed immediately
prior to CCTA.
- Abbara S.
- Blanke P.
- Maroules C.D.
- et al.
SCCT guidelines for the performance and acquisition of coronary computed tomographic
angiography: a report of the society of cardiovascular computed tomography guidelines
committee: endorsed by the north American society for cardiovascular imaging (NASCI).
J Cardiovasc Comput Tomogr. 2016; 10: 435-449
2
Reasons often cited in support of performing CAC prior to CCTA include that the presence
and severity of coronary calcifications may help to optimize CCTA acquisition parameters
(e.g., peak tube potential, tube current, and/or type of electrocardiographic gating
or triggering) to ensure good image quality, that the visualization of extensive CAC
may help determine the diagnostic feasibility and utility of CCTA, and that CAC conveys
important prognostic information. Those opposed to the routine CAC testing prior to
CCTA note that its performance exposes the patient to additional radiation, with CAC
significantly increasing the dose proportionally in the current era of lower CCTA
radiation imaging, or that the prognostic findings from CAC are not additive to CCTA.
An evaluation of the performance and perceived utility of CAC scanning in patients
undergoing CCTA has not been performed.- Villines T.C.
- Hulten E.A.
- Shaw L.J.
- et al.
Prevalence and severity of coronary artery disease and adverse events among symptomatic
patients with coronary artery calcification scores of zero undergoing coronary computed
tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation
for Clinical Outcomes: an International Multicenter) registry.
J Am Coll Cardiol. 2011; 58: 2533-2540
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References
- SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the society of cardiovascular computed tomography guidelines committee: endorsed by the north American society for cardiovascular imaging (NASCI).J Cardiovasc Comput Tomogr. 2016; 10: 435-449
- Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter) registry.J Am Coll Cardiol. 2011; 58: 2533-2540
- Guidelines for reporting survey-based research submitted to academic medicine.Acad Med. 2018; 93: 337-340
- The survey checklist (Manifesto).Acad Med. 2018; 93: 360-366
Article info
Publication history
Published online: December 15, 2022
Accepted:
December 3,
2022
Received in revised form:
November 24,
2022
Received:
October 21,
2022
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Manuscript data was presented in poster format (and published abstract) at the 2022 American College of Cardiology Scientific Sessions (April 4, 2022, Washington, DC).
Identification
Copyright
© 2022 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
