Studies back coronary CTA, and other recent research

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Evan Godt, Editorial Director

A summary of trends in cardiac CT presented last month at the American College of Cardiology (ACC) scientific session in Washington, D.C., provided an opportunity for a victory lap of sorts for coronary CT angiography (CTA) in the emergency department (ED).

After summarizing recent advances in scanner technology, Ricardo C. Cury, MD, of Baptist Hospital of Miami, gave a brief overview of some recent research into the utility of coronary CTA in the ED, focusing on three headline-grabbing titles.

Coronary CTA for acute low-risk chest pain was found to be feasible in the CT-STAT (Coronary CTA for Systematic Triage of Acute Chest Pain Patients to Treatment) trial from Goldstein et al. Costs of of care were shown to be 38 percent lower with CTA compared with the standard of care.

The ACRIN-PA trial from Litt et al also supported the technology’s feasibility, and showed that a coronary CTA-based strategy for low and intermediate risk patients led to faster discharge from the ED for those with possible acute coronary syndrome.

Lastly, Cury highlighted the ROMICAT-II trial from Hoffmann et al, which found a triage strategy featuring coronary CTA for patients with suspected acute coronary syndrome improved efficiency of clinical decision making. Early CTA reduced patient length of stay by more than seven hours and led to more discharges from the ED with no undetected acute coronary syndromes compared with the standard of care.

Looking at some of the other big headlines of the past month, a study published March 14 in Radiology found one approach to analyzing neuroimaging data from diffusion-tensor imaging (DTI) for mild traumatic brain injuries (TBI) could bias diagnosis. The “pothole” analysis—which looks for clusters of voxels in which there is low white matter fractional anisotropy—was called into question as its ability to discern the number of potholes between TBI patients and controls may not be as great as suspected.

Shifting from neuroimaging to CT colonography (CTC), another top headline this month featured a study of a new in vivo radiation dose measurement technique. Published in the April issue of the American Journal of Roentgenology, the study demonstrated that the average size-specific dose estimate error was 7.2 percent when using the in vivo radiation dose measurement technique for CTC.

What research headlines caught your eye this month?

-Evan Godt
Editor – Health Imaging