Italian Registry of Cardiac Computed Tomography



Cardiac CT (CCT) is an imaging modality that is becoming a standard in clinical cardiology. We evaluated indications, safety, and impact on patient management of routine CCT in a multicenter national registry.

Materials and methods

During a period of 6 months, 47 centers in Italy enrolled 3,455 patients.


CCT was performed mainly with 64-slice CT scanners (73.02 %). Contrast agents were administrated in 3,185 patients (92.5 %). Mean DLP changes with type of scanner and was lower in >64 row detector scanner. The most frequent indication for CCT was suspected CAD (44.8 %), followed by calcium scoring (9.6 %), post-angioplasty/stenting (8.3 %), post-CABGs (7.5 %), study of cardiac anatomy (4.22 %) and assessment in patients with known CAD (4.1 %) and acute chest pain (1.99 %). Most of the CCTs were performed in outpatient settings (2,549; 74 %) and a minority in inpatient settings (719, 20.8 %). Adverse clinical events (mild–moderate) occurred in 26 examinations (0.75 %). None of them was severe. In 45.3 % of the cases CCT findings impacted patient management.


CCT is performed with different workloads in participating centers. It is a safe procedure and its results have a strong impact on patient management.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. 1.

    Achenbach S et al (2001) Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated multislice computed tomography. Circulation 103:2535–2538

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Sun Z et al (2006) Diagnostic value of multislice CT angiography in coronary artery disease: a meta-analysis. Eur J Radiol 60:279–286

    Article  PubMed  Google Scholar 

  3. 3.

    Levin et al (2006) The controversy over advanced cardiovascular imaging: relative roles of radiologists, cardiologists, and other physicians in CT and MRI of the cardiovascular system. J Am College Radiol JACR 3(1):16–18

    Article  Google Scholar 

  4. 4.

    Di Cesare E et al (2012) Clinical indications for cardiac computed tomography. From the working group of the cardiac radiology Section of the Italian Society of Medical Radiology (SIRM). Radiol med 117:901–938

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Hendel et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48:1475–1497

  6. 6.

    Taylor AJ et al (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 56:1864–1894

    Article  PubMed  Google Scholar 

  7. 7.

    Fox et al (2006) Guidelines on the management of stable angina pectoris: executive summary: the Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 27:1341–1381

    Article  Google Scholar 

  8. 8.

    Maffei E et al (2010) Low dose CT of the heart: a quantum leap into a new era of cardiovascular imaging. Radiol Med 115:1179–1207

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Carbonaro et al (2006) International, multidisciplinary update of the appropriateness criteria for cardiac computed tomography. J Cardiovasc Comput Tomogr 2009(3):224–232

    Google Scholar 

  10. 10.

    Schroeder et al (2008) Cardiac computed tomography: indications, applications, limitations, and training requirements: report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur Heart J 29:531–556

    Article  PubMed  Google Scholar 

  11. 11.

    Dorfman AL et al (2007) Risk factors for adverse events during cardiovascular magnetic resonance in congenital heart disease. J Cardiovasc Magn Reson 9(5):793–798

    Article  PubMed  Google Scholar 

  12. 12.

    Stein et al (2008) 64-slice CT for diagnosis of coronary artery disease: a systematic review. Am J Med 121:715–725

    Article  PubMed  Google Scholar 

  13. 13.

    Srichai MB, Lim RP, Donnino R, Mannelli L, Hiralal R, Avery R, Ho C, Babb JS, Jacobs JE (2012) Low-dose, prospective triggered high-pitch spiral coronary computed tomography angiography: comparison with retrospective spiral technique. Acad Radiol 19(5): 554–61

  14. 14.

    Di Cesare E, Gennarelli A,Di Sibio A, Felli V, Splendiani A, Gravina GL, Barile A, Masciocchi C (2014) Assessment of dose exposure and image quality in coronary angiography performed by 640- slice CT: a comparison between adaptive iterative and filtered back-projection algorithm by propensity analysis. Radiol Med 119(8): 642–9

  15. 15.

    Oudkerk et al (2008) Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging. Eur Radiol 18:2785–2807

    Article  PubMed  Google Scholar 

  16. 16.

    Hoang MV, Linnau KF, Gill EA, Lehnert BE, Mannelli L (2012) Computed tomography diagnosis of myocardial infarction in a patient with normal initial cardiac biomarkers. Emerg Radiol 19(1): 75–8

  17. 17.

    Ropers et al (2006) Diagnostic accuracy of noninvasive coronary angiography in patients after bypass surgery using 64-slice spiral computed tomography with 330-ms gantry rotation. Circulation 114:2334–2341

    Article  Google Scholar 

  18. 18.

    Malagutti et al (2006) Use of 64-slice CT in symptomatic patients after coronary bypass surgery: evaluation of grafts and coronary arteries. Eur Heart J 28:1879–1885

    Article  Google Scholar 

  19. 19.

    Meyer et al (2007) Improved noninvasive assessment of coronary artery bypass grafts with 64-slice computed tomographic angiography in an unselected patient population. J Am Coll Cardiol 49:946–950

    Article  Google Scholar 

  20. 20.

    Hamon et al (2008) Diagnostic performance of 16- and 64-section spiral CT for coronary artery bypass graft assessment: metaanalysis. Radiology 247:679–686

    Article  PubMed  Google Scholar 

  21. 21.

    Martuscelli et al (2008) Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography. Circulation 110:3234–3238

    Article  Google Scholar 

  22. 22.

    Cappato R, Calkins H, Chen SA (2005) Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation 111:1100–1105

    Article  PubMed  Google Scholar 

  23. 23.

    Benini K, Marini M, Del Greco M et al (2008) Role of multidetector computed tomography in the anatomical definition of the left atrium-pulmonary vein complex in patients with atrial fibrillation. Personal experience and pictorial assay. Radiol Med 113:779–798

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Di Cesare E, Gennarelli A, Di Sibio A, Felli V, Splendiani A, Gravina GL, Barile A, Masciocchi C (2014) Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: a comparison between patients with chronic Atrial Fibrillation and subjects in normal sinus rhythm by propensity analysis. Eur J Radiol. doi:10.1016/j.ejrad.2014.11.035

  25. 25.

    Yang L, Zhou T, Zhang R, Xu L, Peng Z, Ding J, Wang S, Li M, Sun G (2014) Meta-analysis: diagnostic accuracy of coronary CT angiography with prospective ECG gating based on step-and-shoot, Flash and volume modes for detection of coronary artery disease. Eur Radiol 24(10):2345–2352

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Author information




Corresponding author

Correspondence to Ernesto Di Cesare.

Additional information

F. Cademartiri and E. Di Cesare contributed equally to this work.

The list of members of the CCT Italian Registry Group is given in "Appendix”.

CCT Italian Registry Group

CCT Italian Registry Group

Rocco Donato*1, Filippo Zerboni*2, Silvia Tresoldi*3, Carlo Tessa*4, Marco Rengo*5, Giuseppina Manglaviti*6, Massimiliano Danti*7, Federico Crusco*8, Lucia Carotti*9, Bruno Beomonte Zobel*10, Antonio Bernardini*11, Arnaldo Scardapane*12, Simone Banderali*13, Manlio Acquafresca*14, Luca Maria Carusi*15, Umberto Negro*16, Roberto Priotto*17, Francesco De Cobelli*18, Matteo Quarenghi*19, Silvia Paganoni*20, Francesco Secchi*21, Nicola Sforza*22, Domenico Lumia*23, Roberto De Rosa*24, Ernesto Bissoli*25, Luca Olivotti*26, Giulio Barbiero*27, Maurizio Centonze*28, Rodolfo Leurini*29, Roberto Malagò*30, Dario Pinto*31.

*1Azienda Ospedaliera Universitaria G. Martino Me IRCCS Policlinico San Donato, Radiology Unit, Mi.

*2Radiologia, Ospedale Saronno, Va.

*3Ospedale San Paolo, Mi.

*4Ospedale Verilia Camaiore,Lucca.

*5ICOT Latina, Polo Pontino, Università Sapienza.

*6Centro Diagnostico Italiano, MI.

*7M.G. Vannini “Figlie di San Camillo”, Roma.

*8Nuovo Ospedale San Giovanni Battista, Foligno, PG.

*9Ospedale S. Croce, Fano, PU.

*10Diagnostica per Immagini Università Campus Bio-medico, Roma.

*11Ospedale Civile Mazzini, Te.

*12AUO Policlinico Consorziale, Bari.

*13EO Ospedali Galliera, GE.

*14Azienda Ospedaliera-Universitaria Careggi, FI.

*15Ospedale San Giovanni di Dio, FI.

*16ASUR 8 Civitanova Marche, MC.

*17Osp S. Croce e Carle, FI.

*18Radiologia IRCCS San Raffaele, MI.

*19Policlinico, Monza.

*20Ospedale Bolognini, Seriate, BG.

*21IRCCS Policlinico San Donato, San Donato Milanese, MI.

*22San Giovanni Rotondo, FG.

*23Circolo e Fondazione Macchi, Varese.

*24Cliniche Riunite, Napoli.

*25Ospedale Civile Città di Camposampietro, PD.

*26Ospedale Santa Corona, Pietra Ligure, SV.

*27Ospedale San Bassiano, Bassano del Grappa, VI.

*28Ospedale Santa Chiara, Trento.

*29Ospedale Infermi, Rimini.

*30Policlinico Universitario G. Rossi, Verona.

*31Ricerche Radiologiche SRL, Molfetta, BA.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cademartiri, F., Di Cesare, E., Francone, M. et al. Italian Registry of Cardiac Computed Tomography. Radiol med 120, 919–929 (2015).

Download citation


  • Heart diseases
  • Coronary artery
  • Cardiac CT
  • Indications
  • Registry