Is dual-source CT coronary angiography ready for the real world?

Extract

CT coronary angiography (CTCA) represents one of the major innovations in cardiac imaging over the past 10 years. The introduction of 64-slice^1,2 and dual-source^3,4 CT scanners allowed the clinical implementation of this technique in non-invasive coronary artery imaging.

The pros of CTCA are: non-invasiveness; the ability to visualize both the lumen and the coronary artery wall, and consequently to identify atherosclerotic plaques; and the ability to investigate the spatial relationships between cardiac structures.

More than 5000 scanners with ≥64 slices are installed around the world and more than 4000 have cardiac imaging capabilities. These figures are continually growing.

However, the proper use of this tool is still under discussion and for some researchers is even controversial. Studies dealing with clinical outcome and cost-effectiveness are still lacking, and several limitations and concerns have been raised about the clinical implementation of this imaging modality.

Alkadhi et al.⁵ report the diagnostic accuracy of dual-source CTCA (DSCT) in a population at intermediate cardiovascular risk, with regard to important parameters such as obesity, calcium load, and heart rate.