Computed Tomography

Cardiac computed tomography (CT) has become a primary cardiovascular imaging modality in the past 20 years, and was recommended as a 1A recommendation in the 2021 chest pain assessment guidelines. CT calcium scoring has became a primary risk assessment for coronary artery disease and whether patients should be on statins. Coronary CT angiography (CCTA) is used to for anatomical assessment of the arteries for plaque burden and to identify areas of blockage that may cause ischemia and heart attacks. Additional use of contrast CT perfusion or fractional flow reserve CT (FFR-CT) can offer physiological information on the function of the heart. CT plays a primary role in structural heart assessments for heart valves, repair of congenital defects and left atrial appendage occlusion (LAAO) for both pre-procedure planning and procedural guidance. Find more news on general radiology CT use.

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

VIDEO: AMA will ask Congress to revise clinical decision support mandate for cardiac imaging

American Society of Nuclear Cardiology (ASNC) delegates to the American Medical Association (AMA) House of Delegates 2022 meeting Stephen Bloom, MD, and Nishant Shah, MD, explain a new AMA policy asking Congress to revise its clinician decision support mandate. 

The American Medical Association (AMA) Board of Delegates approved a policy calling on payers to reimburse for the drug regadenoson and not to employ payment policies that push for cardiologists to change the drug they use for pharmacologic stress for one that is considered less safe. The policy was adopted at the AMA 2022 meeting. #AMA #AMA175 #AMAmtg #ASNC

AMA supports reimbursement for pharmacologic stress agent regadenoson

The American Medical Association Board of Delegates approved a policy calling on payers to reimburse for the drug regadenoson and not to employ payment policies that push for cardiologists to change the drug they use for pharmacologic stress for one that is considered less safe.

There have been a big increase in interest in cardiac CT following the publication of the 2021 ACC Chest Pain Evaluation Guidelines, which raised CT angiography (CTA) to a 1A level of evidence. This has prompted many centers to consider creating CTA programs.

VIDEO: Cardiac CT training requirements for radiologists and technologists

Brian Ghoshhajra, MD, division chief, cardiovascular imaging, Massachusetts General Hospital, explains what specialized training is needed to perform coronary computed tomography angiography (CCTA) as interest rapidly rises in this field. 

Brian Ghoshhajra, MD, MBA, division chief, cardiovascular imaging, Massachusetts General Hospital and associate professor of radiology, Harvard Medical School, and a board member of the Society of cardiovascular Computed Tomography (SCCT) explains the rapidly expanding interest in cardiac computed tomography (CT) under the new chest pain evaluation guidelines.

VIDEO: The new role of cardiac CT in chest pain evaluation

Brian Ghoshhajra, MD, MBA, division chief, cardiovascular imaging, Massachusetts General Hospital and associate professor of radiology, Harvard Medical School, and a board member of the Society of cardiovascular Computed Tomography (SCCT), explains the rapidly expanding interest in cardiac computed tomography (CT) under the new chest pain evaluation guidelines.

An example of spectral cardiac CT being used to show iodine density in the myocardium to show perfusion deficits. Shown by Philips healthcare at ACC 2022.

VIDEO: Mitigating the contrast media shortage impact on CT imaging

Brian Ghoshhajra, MD, MBA, division chief, cardiovascular imaging, Massachusetts General Hospital and associate professor of radiology, Harvard Medical School, explains the impact of the iodine contrast shortage on computed tomography (CT) and cardiac imaging.
 

Contrast shortage update: GE expects supply to 'progressively recover' soon

Production at the facility in Shanghai is expected to be near 100% starting on June 6.

Iodine contrast being loaded into a contrast injector in preparation for a cardiac CT scan at Duly Health and Care in Lisle, Illinois. The contrast shortage is causing some healthcare organizations to postpone exams and procedures and ration contrast supplies. Photo by Dave Fornell

ACR working with FDA and HHS to help address imaging contrast shortage

The American College of Radiology (ACR) announced this week its government relations staff has been engaging federal agencies in an effort to improve product availability and hasten resolution of the ongoing iodine contrast shortage.

Interview with Alan H. Matsumoto, MD, FSIR, FACR, FAHA, professor of radiology, chair of the Department of Radiology at the University of Virginia, vice chair of the American College of Radiology (ACR) Board of Chancellors, and the chairman of the ACR Commission on Interventional and Cardiovascular Radiology. He explains how the ACR and group purchasing organizations are asking the FDA to mitigate the contrast shortage with an emergency use authorization (EUA) to allow non-FDA cleared iodine contrast use.

VIDEO: American College of Radiology working with FDA to mitigate contrast shortage

Alan Matsumoto, MD, chair of the department of radiology at the University of Virginia and vice chair of the ACR Board of Chancellors, explains how the ACR and group purchasing organizations are asking the FDA to mitigate the contrast shortage with an emergency use authorization to allow non-FDA cleared iodine contrast agents to be imported.

Around the web

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

The all-in-one Omni Legend PET/CT scanner is now being manufactured in a new production facility in Waukesha, Wisconsin.