While Goethe's statement is reflective of humanity's philosophical nature, cardiologists and radiologists who examine images of the heart are privy to both the behavioral and genealogical nature of its owner, which contribute to an individual's physiological construction. The annual meeting of the Society of Cardiovascular Computed Tomography (SCCT) brought together these physicians, who formulate diagnoses based on the examination of cardiac images, last week in Orlando, Fla.
As the CT technologies rapidly evolve, the standards and guidelines must struggle to maintain pace. Interestingly, poll results showed that it might already be time to re-evaluate the 2006 Appropriateness Criteria for Cardiac CT. Those surveyed indicated a desire for more indications under ‘appropriate,' including the controversial triple-rule out exam. Apparently, the scheduled criteria review by the ACC next year can't come soon enough.
Also, several clinical studies indicated that CCTA continues to prove its worth. One study found that CCTA can determine that certain left ventricular (LV) metrics correlate with the degree of coronary plaque burden in patients without LV hypertrophy, which could possibly provide an indication to intensify medical therapy in patients with subclinical coronary artery disease (CAD) and hypertension. In another study, CCTA found both calcified and non-calcified plaque in a large diagnostic population of patients with coronary artery calcium (CAC) scores of zero.
Also, innovative researchers are learning how to take these technologies further. An unfunded proof-of-concept study showed high sensitivity and negative predictive value among evaluable arteries when viewing CCTA images over an Apple iPhone. The researchers used their own PDAs, along with a downloadable software application, to assess 50 consecutive patients with a relatively low presence of CAD. While this evaluative technique is not currently FDA approved and no post-processing software is available, lead author Dr. Troy LaBounty told Cardiovascular Business News that the more mobile nature of physicians should allow for more remote options in the future.
Even a slight view into the SCCT conference allows the cardiovascular community to see how the field of heart imaging is shaping the treatment patients--not to mention the options for imagers..
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