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

Video Plus Brochure Helps Patients Make Lung Cancer Scan Decision

Image courtesy of the American Thoracic Society

News | Lung Cancer | April 19, 2019
A short video describing the potential benefits and risks of low-dose computed tomography (CT) screening for lung...
FDA Clears GE's Deep Learning Image Reconstruction Engine
Technology | Computed Tomography (CT) | April 19, 2019
GE Healthcare has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) of its Deep Learning Image...
Artificial Intelligence Performs As Well As Experienced Radiologists in Detecting Prostate Cancer
News | Artificial Intelligence | April 18, 2019
University of California Los Angeles (UCLA) researchers have developed a new artificial intelligence (AI) system to...
Ebit and DiA Imaging Analysis Partner on AI-based Cardiac Ultrasound Analysis
News | Cardiovascular Ultrasound | April 16, 2019
DiA Imaging Analysis has partnered with the Italian healthcare IT company Ebit (Esaote Group), to offer DiA’s LVivo...
A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images

A smart algorithm has been trained on a neural network to recognize the appearance of breast cancer in MR images. The algorithm, described at the SBI/ACR Breast Imaging Symposium, used “Deep Learning,“ a form of machine learning, which is a type of artificial intelligence. Graphic courtesy of Sarah Eskreis-Winkler, M.D.

Feature | Artificial Intelligence | April 12, 2019 | By Greg Freiherr
The use of smart algorithms has the potential to make healthcare more efficient.
DiA Imaging Analysis Introduces LVivo SAX Ultrasound Analysis Tool
Technology | Cardiovascular Ultrasound | April 09, 2019
DiA Imaging Analysis announced the launch of LVivo SAX, a cardiac analysis tool that helps clinicians quickly and...
Videos | RSNA | April 03, 2019
ITN Editor Dave Fornell takes a tour of some of the most interesting new medical imaging technologies displa
Johns Hopkins Medicine First in U.S. to Install Canon Medical's Aquilion Precision
News | Computed Tomography (CT) | March 26, 2019
March 26, 2019 — Johns Hopkins Medicine now has access to the first...