Healthcare Imaging & IT - July 2008 - (Page 30)

Cardiac CT Angiography: A Clear Pathway to Better Cardiac Patient Management Visit us at AHRA in Denver July 28-30 Booth 140/142 a potential problem in patients with renal Future indications disease and for patients allergic to them. Despite volumes of research data available While it would be easy to send everyone that promote the proven benefits of CCTA, it with chest pain through a CT scanner, it does is still a technology in development. Further not make economical, clinical or ethical sense, studies need to be conducted to show an due to the radiation doses, especially in youngappropriate use of the test in appropriate er patients, who need to be closely monitored populations, says Julie Miller, MD, assistant for radiation exposure. According to Jerry professor of medicine at Johns Hopkins HosHines, MD, president and CEO of Illinois pital in Baltimore. Miller was the lead invesHeart and Vascular in Hinsdale, Ill., a singletigator for the CorE 64 study, who presented specialty private practice with 27 cardiologists, the results at the 2007 American Heart Assoaside from eliminating needless testing, there ciation meeting in Orlando, Fla. have been protocol changes to The nine-center, seven-country, CCTA that have lowered radiamulti-site Coronary Artery tion exposure for patients. Evaluation using 64-Row “By lowering our Kv Multidetector Computed from 120 to 100, by Tomography (CorE-64) dose modulating all of showed that 64-row our studies and by multidetector CT, for using prospective gatcoronary artery evaluaing, we were able to tion in patients with susconsiderably lower pected CAD and with radiation exposure for calcium scores less than our patients,” Hines says. 600, could assess the presWith the Lightspeed ence of significant CAD [ Contrast-enhanced retrospectively gated VCT from GE Healthjust as well as cardiac Dual Energy CT study on a Siemens Somatom care, which has Snapcatheterization. Using Definition using DE Heart Perfused Blood Volume protocol on a high risk 72-year-old male the Toshiba Aquilion 64 Shot Pulse technology with no history of CAD. 3D volume-rendered for cardiac dose control, CFX multidetector CT image shows a high degree of stenosis due to predominately calcified atherosclerotic plaque in addition to dose modscanners from Toshiba subsequently confirmed by catheterization. Courtesy of Siemens Medical Solutions and ulation, cardiologists are America Medical SysMedical University of South Carolina. ] able to have x-ray on all tems for imaging, the the time, but at a lower dose in portions of the study was the first step taken by the industry cardiac cycle that are not as clinically relevant. to realize the full potential of CT imaging in “Pulse technology has the potential to lower predicting CAD. radiation exposure from 10 percent of nor“CorE-64 was the first step because assessmal levels—normally 10 to 15 millisieverts to ing the diagnostic accuracy in symptomatic approximately 2 millisieverts.” Hines notes patients was necessary, but now it is time to this is not applicable to all patients. look toward how to use it in clinical practice If a patient has suspected cardiac disease to actually alter care,” Miller adds. “We need symptoms, and if there are no indications of to show an appropriate diagnostic use of the an acute ischemic event, then that patient test in the appropriate population. If the should be considered for CCTA. “If there is diagnosis can be made by other means that evidence of acute ischemic event, then an do not involve radiation, that would be betelective CT scan is not our first choice,” he ter. But, if we can identify patients earlier or adds. “In patients with atypical chest pain, or not send out patients from the ER who then with chest pain that is clearly not cardiac in have a cardiac event, that is useful.” origin, CT has been a marvelous tool in rulWith the first step taken, many within the ing out coronary disease to avoid invasive industry feel the next step is to determine procedures and associated radiation risks.” whether CCTA can be used as a screening HealthImaging.com 30 Health Imaging & IT | July 2008 http://www.erad.com http://www.erad.com http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Healthcare Imaging & IT - July 2008

Healthcare Imaging & IT - July 2008 On the Web The Enterprise News Update Convention Spotlight: AHRA 2008 Cover Story: Driving Metrics to Drive Business: Digital Dashboards Deliver Mammography CAD Comes of Age Breast MR CAD: Earlier Detection, Increased Efficiency Lung CAD Earning a Spot in Day-to-Day Practice Colon CAD: Breaking Down Barriers Modality Review: Cardiac CT Angiography: A Clear Pathway to Better Cardiac Patient Management Practice Management: RIS Rights Efficiency & Productivity Wrongs In Practice: Advanced Visualization Across the Enterprise Regulatory Update: Beware: Recovery Audit Contractors Poised for Permanent Status Technology Outlook: Compressing Images for Remote Transmission Reader's Resource Stat Sheet

Healthcare Imaging & IT - July 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.