News | July 08, 2008

AHA Issues New Guidelines for CT, MR Coronary Angiography

July 9, 2008 – The American Heart Association recently issued new guidelines for computed tomography (CT) and magnetic resonance (MR) angiography, which state CT is the better imaging technology, but MR offers more patient safety because it does not use ionizing radiation.

The authors of the guidelines wrote noninvasive coronary CT and MR represent substantial advances that may ultimately be valuable for diagnosis of significant coronary artery disease. The chief advantages of coronary CT compared with MR are wider availability, higher spatial resolution, and more consistent, shorter examinations with better patient adherence. Advantages associated with coronary MR are a lack of radiation and a lack of administration of iodinated contrast material. However, the authors of the guidelines said both tests are presently suboptimal for patients with atrial fibrillation and other arrhythmias, and image quality may be further reduced by high body mass.

The new AHA guidelines state:

1. Neither coronary CT nor MR should be used to screen for coronary artery disease in patients who have no signs or symptoms suggestive of coronary artery disease.

2. The potential benefit of noninvasive coronary angiography is likely to be greatest and is reasonable for symptomatic patients who are at intermediate risk for coronary artery disease after initial risk stratification, including patients with equivocal stress-test results. Diagnostic accuracy favors coronary CT over MR for these patients.

3. Concerns regarding radiation dose limit the use of coronary CT in high-risk patients who have a very low pretest likelihood of coronary stenoses. Patients with a high pretest likelihood of coronary stenoses are likely to require intervention and invasive catheter angiography for definitive evaluation, so CT is not recommended for these individuals. Pronounced coronary calcification may negatively impact interpretability and accuracy of coronary CT so the usefulness of CT is uncertain in these individuals.

4. Anomalous coronary artery evaluation can be performed by either CT or MR. Radiation-protection concerns indicate that MR is preferred when it is available.

5. Reporting of coronary CT and MR results should describe any limitations to the technical quality of the examination and the size of the vessels, descriptions of coronary anomalies, coronary stenosis, and significant noncardiac findings within the field of view.

6. Continued research in cardiac CT and MR imaging is encouraged to determine the potential of these noncatheter-based modalities to detect, characterize, and measure atherosclerotic plaque burden, as well as its change over time or as the result of therapy. No multi-vendor trial data is available for coronary CT or for present whole-heart coronary MR, so the applicability of these methods beyond the reporting research centers is not known.

Specific recommendations for use of these technologies are expected to change along with advances in scanner hardware and software, the report said.

For more information: www.americanheart.org/presenter.jhtml?identifier=3004557

Related Content

Report Finds Identifying Patients for Lung Cancer Screening Not So Simple
News | Lung Cancer | June 18, 2018
New findings in the current issue of The American Journal of Managed Care suggest that getting the right patients to...
Elekta Unity High-Field MR-Linac Receives CE Mark
News | Image Guided Radiation Therapy (IGRT) | June 18, 2018
Elekta announced that its Elekta Unity magnetic resonance radiation therapy (MR/RT) system has received CE mark,...
Weight-Bearing CT International Study Group Hosts  Scientific Session at AOFAS Conference
News | Computed Tomography (CT) | June 15, 2018
June 15, 2018 —The Weight-Bearing CT International Study Group will host a scientific session on the benefits of weig
Florida Hospital First in State to Adopt NeuroLogica's BodyTom Elite CT
News | Computed Tomography (CT) | June 14, 2018
June 14, 2018 — NeuroLogica, a subsidiary of Samsung Electronics Co.
Washington University in St. Louis Begins Clinical Treatments With ViewRay MRIdian Linac
News | Image Guided Radiation Therapy (IGRT) | June 14, 2018
June 14, 2018 — The Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in S
Riverain Technologies Issued U.S. Patent for Vessel Suppression Technology
News | Computed Tomography (CT) | June 14, 2018
Riverain Technologies announced that the United States Patent and Trademark Office (USPTO) has awarded the company a...
360 Photos | 360 View Photos | June 14, 2018
This is a 360 degree image from the Canon Aquilion 64-slice...
American Society of Neuroradiology Honors Peter Chang with Cornelius G. Dyke Memorial Award
News | Neuro Imaging | June 13, 2018
Peter Chang, M.D., current neuroradiology fellow at UCSF and recently recruited co-director of the UCI Center for...
Reduced hippocampal volume on MRI

This figure shows reduced hippocampal volume over the course of 6 years as seen on progressive volumetric analysis and also coronal MRI evaluations (arrows).Progressive volume loss in the mesial temporal lobe on MRI is a characteristic imaging feature of AD. This patient was a case of Alzheimer’s Dementia.

 

News | Neuro Imaging | June 12, 2018
According to a UCLA Medical Center study, a new technology shows the potential to help doctors better determine when...
NewYork-Presbyterian Expands Mobile Stroke Treatment Unit Fleet

Image courtesy of NewYork-Presbyterian Hospital

News | Stroke | June 11, 2018
NewYork-Presbyterian, in collaboration with Weill Cornell Medicine, Columbia University Irving Medical Center and the...
Overlay Init