The AHA Guidelines and Scientific Statements Handbook

Cardiac CT Imaging

Matthew J. Budoff and Allen J. Taylor

20

Scientifi c Statement on Cardiac CT – 2006

Coronary calcium scanning

Summary from the AHA Scientifi c Statement

Coronary calcium scanning

Additional statements/guidelines related to coronary

artery calcium

ACC/AHA Expert Consensus Document on coronary

calcium

Comparison with European Guidelines

Cardiac CT Angiography – Scientifi c Statement 2006

Hybrid imaging with CT and nuclear imaging

Recommendations

CT angiography

Hybrid scanning (nuclear and CT)

Ongoing trials

Future directions

Tracking progression of subclinical atherosclerosis

Conclusions

2008 Statement on noninvasive coronary artery

imaging: MR angiography and multi-detector CT

angiography

Specifi c recommendations for use of CTA and MRA

ACCF/AHA 2007 clinical competence statement on

vascular imaging with computed tomography and

magnetic resonance

CT angiography

Specifi c applications

Magnetic resonance angiography

Scientifi c Statement on Cardiac

CT – 2006 [1]

During the past decade, there has been a progressive

increase in the clinical use of cardiac computed

tomography scanning to identify and quantify the

amount of coronary artery calcifi ed plaque (CACP),

leading to both much interest and scrutiny. On the

basis of the substantial validation data, electron beam

computed tomography (EBCT) remains the refer-

ence standard for CACP measurement. The technol-

ogy of cardiac computed tomography has undergone

rapid transformation in recent years such that new

scanners with sub-second image acquisition multi-

row capability have been studied and now multi-

detector computed tomography (MDCT) is suggested

as an alternative approach to EBCT to detect coro-

nary calcifi cation which may broaden the availability

of CACP detection as a consequence of the greater

availability of such scanners. Thus, although coronary

calcifi cation can be quantifi ed and calcium scores can

be related to extent and severity of atherosclerotic

disease and its prognosis, misuse or abuse of these

methods as a broad-based “screening” tool has created

considerable controversy.

This statement reviews the scientifi c data for

cardiac computed tomography (CT) related to

imaging of coronary artery disease and atheroscle-

rosis. Cardiac CT is a computed tomographic

imaging technique that accounts for cardiac motion,

typically through the use of ECG gating. The utility

and limitations of generations of cardiac CT systems

are reviewed in this statement with emphasis on CT

measurement of coronary artery disease and coro-

nary artery calcifi ed plaque (CACP) and noncalci-

fi ed plaque (CANCP).

The committee directing the generation of this

document was composed of representatives of

the AHA, Society of Atherosclerosis Imaging and

Prevention (SAI-P) and Society of Cardio-

vascular Computed Tomography. The document

was reviewed by individuals nominated by these

organizations. This statement updates the 2000 sci-

entifi c statement on Electron Beam Computed

The AHA Guidelines and Scientific Statements Handbook
Edited by Valentin Fuster © 2009 American Heart Association
ISBN: 978-1-405-18463-2