Cardiac CT exhibits clinical, cost benefits despite radiation risk

March 4, 2008 Diagnostic Imaging. Cardiac CT exhibits clinical, cost benefits despite radiation risk Dual-source or 64-slice CT examination proves quick, noninvasive, and effective in triaging patients with low to moderate risk of heart disease CHRISTOPH R. BECKER, M.D. -------------------------------------------------------------------------------- Increasing efforts to screen and diagnose coronary artery disease have used imaging modalities such as catheter angiography, ultrasound, and MRI. Electron-beam CT was, for a long time, the only CT system able to image the coronary arteries without motion artifacts. But multislice CT has advanced rapidly over the last decade, and state-of-the-art 64-slice and dual-source CT now offer high-quality imaging of the coronary arteries, myocardium, and valves, providing morphological and even functional information. Coronary calcium is a surrogate marker for coronary atherosclerosis, and its levels have been measured by EBCT for more than a decade. Prospective cohort studies are currently under way to measure the value of coronary calcium evaluation against conventional risk factors when estimating the risk of future cardiovascular events. Initial results published from the South Bay Heart Watch study (2000 subjects) show that coronary calcium is of minor predictive value in patients with diabetes and that differences exist in terms of prevalence and progression of coronary calcium in different ethnic groups. 1 The Heinz-Nixdorf RECALL study (4200 subjects) provides unbiased information on the extent of coronary calcium in the general German population. 2

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