Coronary CT Angiography: State of the Art

  • John W. NanceJr.Email author
Part of the Medical Radiology book series (MEDRAD)


Technical advancements in computed tomography have provided the basis for safe, rapid, noninvasive detection of coronary artery disease with high diagnostic accuracy. While there are well-established limitations in the pure anatomic assessment of coronary atherosclerosis, there is a growing body of data demonstrating that coronary computed tomography angiography provides valuable prognostic information and may have outcome and cost benefits over traditional diagnostic testing in selected clinical scenarios. Appropriate utilization necessitates proper technique and patient selection. The exact clinical role of computed tomography-based anatomic assessment of coronary artery disease is still evolving, and emerging techniques are encouraging for improved performance and expanded applications in the future.


Acute Coronary Syndrome Negative Predictive Value Coronary Artery Calcium Coronary Compute Tomography Angiography Major Adverse Cardiac Event 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ahmadi N, Nabavi V, Hajsadeghi F, Flores F, French WJ, Mao SS, Shavelle D, Ebrahimi R, Budoff M (2011) Mortality incidence of patients with non-obstructive coronary artery disease diagnosed by computed tomography angiography. Am J Cardiol 107(1):10–16PubMedCrossRefGoogle Scholar
  2. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE 2nd, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC Jr, Jacobs AK, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B (2007) ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction): developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Circulation 116(7):e148-304Google Scholar
  3. Arnoldi E, Gebregziabher M, Schoepf UJ, Goldenberg R, Ramos-Duran L, Zwerner PL, Nikolaou K, Reiser MF, Costello P, Thilo C (2009) Automated computer-aided stenosis detection at coronary CT angiography: initial experience. Eur Radiol 20(5):1160–1167Google Scholar
  4. Bamberg F, Sommer WH, Hoffmann V, Achenbach S, Nikolaou K, Conen D, Reiser MF, Hoffmann U, Becker CR (2011) Meta-analysis and systematic review of the long-term predictive value of assessment of coronary atherosclerosis by contrast-enhanced coronary computed tomography angiography. J Am Coll Cardiol 57(24):2426–2436PubMedCrossRefGoogle Scholar
  5. Bamberg F, Marcus RP, Schlett CL, Schoepf UJ, Johnson TR, Nance JW Jr, Hoffmann U, Reiser MF, Nikolaou K (2012) Imaging evaluation of acute chest pain: systematic review of evidence base and cost-effectiveness. J Thorac Imaging 27(5):289–295PubMedCrossRefGoogle Scholar
  6. Blackmon KN, Streck J, Thilo C, Bastarrika G, Costello P, Joseph Schoepf U (2009) Reproducibility of automated noncalcified coronary artery plaque burden assessment at coronary CT angiography. J Thorac Imaging 24(2):96–102PubMedCrossRefGoogle Scholar
  7. Bruschke AV, Sheldon WC, Shirey EK, Proudfit WL (2009) A half century of selective coronary arteriography. J Am Coll Cardiol 54(23):2139–2144PubMedCrossRefGoogle Scholar
  8. Budoff MJ, Cohen MC, Garcia MJ, Hodgson JM, Hundley WG, Lima JA, Manning WJ, Pohost GM, Raggi PM, Rodgers GP, Rumberger JA, Taylor AJ, Creager MA, Hirshfeld JW Jr, Lorell BH, Merli G, Rodgers GP, Tracy CM, Weitz HH (2005) ACCF/AHA clinical competence statement on cardiac imaging with computed tomography and magnetic resonance. Circulation 112(4):598–617PubMedCrossRefGoogle Scholar
  9. Budoff MJ, Dowe D, Jollis JG, Gitter M, Sutherland J, Halamert E, Scherer M, Bellinger R, Martin A, Benton R, Delago A, Min JK (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 52(21):1724–1732PubMedCrossRefGoogle Scholar
  10. Buffa V, De Cecco CN, Cossu L, Fedeli S, Vallone A, Ruopoli R, Luzietti M, Angelica G, David V, Musumeci F (2010) Preoperative coronary risk assessment with dual-source CT in patients undergoing noncoronary cardiac surgery. Radiol Med 115(7):1028–1037PubMedCrossRefGoogle Scholar
  11. Carrabba N, Schuijf JD, de Graaf FR, Parodi G, Maffei E, Valenti R, Palumbo A, Weustink AC, Mollet NR, Accetta G, Cademartiri F, Antoniucci D, Bax JJ (2010) Diagnostic accuracy of 64-slice computed tomography coronary angiography for the detection of in-stent restenosis: a meta-analysis. J Nucl Cardiol 17(3):470–478PubMedCrossRefGoogle Scholar
  12. Cheezum MK, Hulten EA, Fischer C, Smith RM, Slim AM, Villines TC (2012) Prognostic value of coronary CT angiography. Cardiol Clin 30(1):77–91PubMedCrossRefGoogle Scholar
  13. Choi EK, Choi SI, Rivera JJ, Nasir K, Chang SA, Chun EJ, Kim HK, Choi DJ, Blumenthal RS, Chang HJ (2008) Coronary computed tomography angiography as a screening tool for the detection of occult coronary artery disease in asymptomatic individuals. J Am Coll Cardiol 52(5):357–365PubMedCrossRefGoogle Scholar
  14. Chow BJ, Ahmed O, Small G, Alghamdi AA, Yam Y, Chen L, Wells GA (2011a) Prognostic value of CT angiography in coronary bypass patients. JACC Cardiovasc Imaging 4(5):496–502PubMedCrossRefGoogle Scholar
  15. Chow BJ, Small G, Yam Y, Chen L, Achenbach S, Al-Mallah M, Berman DS, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Cheng V, Chinnaiyan KM, Delago A, Dunning A, Hadamitzky M, Hausleiter J, Kaufmann P, Lin F, Maffei E, Raff GL, Shaw LJ, Villines TC, Min JK (2011b) Incremental prognostic value of cardiac computed tomography in coronary artery disease using CONFIRM: COroNary computed tomography angiography evaluation for clinical outcomes: an InteRnational Multicenter registry. Circ Cardiovasc Imaging 4(5):463–472PubMedCrossRefGoogle Scholar
  16. Coles DR, Smail MA, Negus IS, Wilde P, Oberhoff M, Karsch KR, Baumbach A (2006) Comparison of radiation doses from multislice computed tomography coronary angiography and conventional diagnostic angiography. J Am Coll Cardiol 47(9):1840–1845PubMedCrossRefGoogle Scholar
  17. den Dekker MA, de Smet K, de Bock GH, Tio RA, Oudkerk M, Vliegenthart R (2012) Diagnostic performance of coronary CT angiography for stenosis detection according to calcium score: systematic review and meta-analysis. Eur Radiol 22(12):2688–2698Google Scholar
  18. Dorenkamp M, Bonaventura K, Sohns C, Becker CR, Leber AW (2011) Direct costs and cost-effectiveness of dual-source computed tomography and invasive coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Heart 98:460–467Google Scholar
  19. Einstein AJ, Henzlova MJ, Rajagopalan S (2007) Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 298(3):317–323PubMedCrossRefGoogle Scholar
  20. Fink C, Krissak R, Henzler T, Lechel U, Brix G, Takx RA, Nance JW, Abro JA, Schoenberg SO, Schoepf UJ (2011) Radiation dose at coronary CT angiography: second-generation dual-source CT versus single-source 64-MDCT and first-generation dual-source CT. AJR Am J Roentgenol 196(5):W550–W557PubMedCrossRefGoogle Scholar
  21. Genders TS, Meijboom WB, Meijs MF, Schuijf JD, Mollet NR, Weustink AC, Pugliese F, Bax JJ, Cramer MJ, Krestin GP, de Feyter PJ, Hunink MG (2009) CT coronary angiography in patients suspected of having coronary artery disease: decision making from various perspectives in the face of uncertainty. Radiology 253(3):734–744PubMedCrossRefGoogle Scholar
  22. Ghostine S, Caussin C, Habis M, Habib Y, Clement C, Sigal-Cinqualbre A, Angel CY, Lancelin B, Capderou A, Paul JF (2008) Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography. Eur Heart J 29(17):2133–2140PubMedCrossRefGoogle Scholar
  23. Goldstein JA, Chinnaiyan KM, Abidov A, Achenbach S, Berman DS, Hayes SW, Hoffmann U, Lesser JR, Mikati IA, O’Neil BJ, Shaw LJ, Shen MY, Valeti US, Raff GL (2011) The CT-STAT (Coronary computed tomographic angiography for systematic triage of acute chest pain patients to treatment) trial. J Am Coll Cardiol 58(14):1414–1422PubMedCrossRefGoogle Scholar
  24. Hadamitzky M, Meyer T, Hein F, Bischoff B, Martinoff S, Schomig A, Hausleiter J (2010) Prognostic value of coronary computed tomographic angiography in asymptomatic patients. Am J Cardiol 105(12):1746–1751PubMedCrossRefGoogle Scholar
  25. Hadamitzky M, Distler R, Meyer T, Hein F, Kastrati A, Martinoff S, Schomig A, Hausleiter J (2011) Prognostic value of coronary computed tomographic angiography in comparison with calcium scoring and clinical risk scores. Circ Cardiovasc Imaging 4(1):16–23PubMedCrossRefGoogle Scholar
  26. Hamilton-Craig C, Strugnell WE, Raffel OC, Porto I, Walters DL, Slaughter RE (2012) CT angiography with cardiac MRI: non-invasive functional and anatomical assessment for the etiology in newly diagnosed heart failure. Int J Cardiovasc Imaging 28(5):1111–1122PubMedCrossRefGoogle Scholar
  27. Hamon M, Lepage O, Malagutti P, Riddell JW, Morello R, Agostini D, Hamon M (2008) Diagnostic performance of 16- and 64-section spiral CT for coronary artery bypass graft assessment: meta-analysis. Radiology 247(3):679–686PubMedCrossRefGoogle Scholar
  28. Hang CL, Lee YW, Guo GB, Youssef AA, Yip HK, Liu CF, Chua S, Chang HW, Cheng YF, Chen SM (2011) Evaluation of coronary artery stent patency by using 64-slice multi-detector computed tomography and conventional coronary angiography: A comparison with intravascular ultrasonography. Int J Cardiol [Epub ahead of print]Google Scholar
  29. Hausleiter J, Meyer T, Hermann F, Hadamitzky M, Krebs M, Gerber TC, McCollough C, Martinoff S, Kastrati A, Schomig A, Achenbach S (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301(5):500–507PubMedCrossRefGoogle Scholar
  30. Hausleiter J, Martinoff S, Hadamitzky M, Martuscelli E, Pschierer I, Feuchtner GM, Catalan-Sanz P, Czermak B, Meyer TS, Hein F, Bischoff B, Kuse M, Schomig A, Achenbach S (2010) Image quality and radiation exposure with a low tube voltage protocol for coronary CT angiography results of the PROTECTION II Trial. JACC Cardiovasc Imaging 3(11):1113–1123PubMedCrossRefGoogle Scholar
  31. Hausleiter J, Meyer TS, Martuscelli E, Spagnolo P, Yamamoto H, Carrascosa P, Anger T, Lehmkuhl L, Alkadhi H, Martinoff S, Hadamitzky M, Hein F, Bischoff B, Kuse M, Schomig A, Achenbach S (2012) Image quality and radiation exposure with prospectively ECG-triggered axial scanning for coronary CT angiography: the multicenter, multivendor, randomized PROTECTION-III study. JACC Cardiovasc Imaging 5(5):484–493PubMedCrossRefGoogle Scholar
  32. Hendel RC (2009) Is computed tomography coronary angiography the most accurate and effective noninvasive imaging tool to evaluate patients with acute chest pain in the emergency department? CT coronary angiography is the most accurate and effective noninvasive imaging tool for evaluating patients presenting with chest pain to the emergency department: antagonist viewpoint. Circ Cardiovasc Imaging 2(3):264–275; discussion 275Google Scholar
  33. Hoffmann U, Nagurney JT, Moselewski F, Pena A, Ferencik M, Chae CU, Cury RC, Butler J, Abbara S, Brown DF, Manini A, Nichols JH, Achenbach S, Brady TJ (2006) Coronary multidetector computed tomography in the assessment of patients with acute chest pain. Circulation 114(21):2251–2260PubMedCrossRefGoogle Scholar
  34. Hoffmann U, Truong QA, Schoenfeld DA, Chou ET, Woodard PK, Nagurney JT, Pope JH, Hauser TH, White CS, Weiner SG, Kalanjian S, Mullins ME, Mikati I, Peacock WF, Zakroysky P, Hayden D, Goehler A, Lee H, Gazelle GS, Wiviott SD, Fleg JL, Udelson JE (2012) Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med 367(4):299–308PubMedCrossRefGoogle Scholar
  35. Hulten EA, Carbonaro S, Petrillo SP, Mitchell JD, Villines TC (2011) Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol 57(10):1237–1247PubMedCrossRefGoogle Scholar
  36. Karlsberg RP, Budoff MJ, Thomson LE, Friedman JD, Berman DS (2010) Reduction in downstream test utilization following introduction of coronary computed tomography in a cardiology practice. Int J Cardiovasc Imaging 26(3):359–366PubMedCrossRefGoogle Scholar
  37. Kazmi MH, Small G, Sleiman L, Chow BJ (2011) Determining patient prognosis using computed tomography coronary angiography. Expert Rev Med Devices 8(5):647–657PubMedCrossRefGoogle Scholar
  38. Khare RK, Courtney DM, Powell ES, Venkatesh AK, Lee TA (2008) Sixty-four-slice computed tomography of the coronary arteries: cost-effectiveness analysis of patients presenting to the emergency department with low-risk chest pain. Acad Emerg Med 15(7):623–632PubMedCrossRefGoogle Scholar
  39. Ladapo JA, Hoffmann U, Bamberg F, Nagurney JT, Cutler DM, Weinstein MC, Gazelle GS (2008) Cost-effectiveness of coronary MDCT in the triage of patients with acute chest pain. Am J Roentgenol 191(2):455–463CrossRefGoogle Scholar
  40. Ladapo JA, Jaffer FA, Hoffmann U, Thomson CC, Bamberg F, Dec W, Cutler DM, Weinstein MC, Gazelle GS (2009) Clinical outcomes and cost-effectiveness of coronary computed tomography angiography in the evaluation of patients with chest pain. J Am Coll Cardiol 54(25):2409–2422PubMedCrossRefGoogle Scholar
  41. Lee CI, Tsai EB, Sigal BM, Plevritis SK, Garber AM, Rubin GD (2010) Incidental extracardiac findings at coronary CT: clinical and economic impact. Am J Roentgenol 194(6):1531–1538CrossRefGoogle Scholar
  42. Lehman SJ, Abbara S, Cury RC, Nagurney JT, Hsu J, Goela A, Schlett CL, Dodd JD, Brady TJ, Bamberg F, Hoffmann U (2009) Significance of cardiac computed tomography incidental findings in acute chest pain. Am J Med 122(6):543–549PubMedCrossRefGoogle Scholar
  43. Leipsic J, Labounty TM, Heilbron B, Min JK, Mancini GB, Lin FY, Taylor C, Dunning A, Earls JP (2010) Estimated radiation dose reduction using adaptive statistical iterative reconstruction in coronary CT angiography: the ERASIR study. Am J Roentgenol 195(3):655–660CrossRefGoogle Scholar
  44. Lichtlen PR, Bargheer K, Wenzlaff P (1995) Long-term prognosis of patients with anginalike chest pain and normal coronary angiographic findings. J Am Coll Cardiol 25(5):1013–1018PubMedCrossRefGoogle Scholar
  45. Lin F, Shaw LJ, Berman DS, Callister TQ, Weinsaft JW, Wong FJ, Szulc M, Tandon V, Okin PM, Devereux RB, Min JK (2008) Multidetector computed tomography coronary artery plaque predictors of stress-induced myocardial ischemia by SPECT. Atherosclerosis 197(2):700–709PubMedCrossRefGoogle Scholar
  46. Litt HI, Gatsonis C, Snyder B, Singh H, Miller CD, Entrikin DW, Leaming JM, Gavin LJ, Pacella CB, Hollander JE (2012) CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med 366(15):1393–1403PubMedCrossRefGoogle Scholar
  47. Lu B, Mao SS, Zhuang N, Bakhsheshi H, Yamamoto H, Takasu J, Liu SC, Budoff MJ (2001) Coronary artery motion during the cardiac cycle and optimal ECG triggering for coronary artery imaging. Invest Radiol 36(5):250–256PubMedCrossRefGoogle Scholar
  48. Mahnken AH (2012) CT imaging of coronary stents: past, present, and future. ISRN Cardiol 2012:139823PubMedGoogle Scholar
  49. Mark DB, Berman DS, Budoff MJ, Carr JJ, Gerber TC, Hecht HS, Hlatky MA, Hodgson JM, Lauer MS, Miller JM, Morin RL, Mukherjee D, Poon M, Rubin GD, Schwartz RS (2010) ACCF/ACR/AHA/NASCI/SAIP/SCAI/SCCT 2010 expert consensus document on coronary computed tomographic angiography: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 55(23):2663–2699PubMedCrossRefGoogle Scholar
  50. Meijboom WB, Meijs MF, Schuijf JD, Cramer MJ, Mollet NR, van Mieghem CA, Nieman K, van Werkhoven JM, Pundziute G, Weustink AC, de Vos AM, Pugliese F, Rensing B, Jukema JW, Bax JJ, Prokop M, Doevendans PA, Hunink MG, Krestin GP, de Feyter PJ (2008) Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol 52(25):2135–2144PubMedCrossRefGoogle Scholar
  51. Metz LD, Beattie M, Hom R, Redberg RF, Grady D, Fleischmann KE (2007) The prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography: a meta-analysis. J Am Coll Cardiol 49(2):227–237PubMedCrossRefGoogle Scholar
  52. Miller JM, Rochitte CE, Dewey M, Arbab-Zadeh A, Niinuma H, Gottlieb I, Paul N, Clouse ME, Shapiro EP, Hoe J, Lardo AC, Bush DE, de Roos A, Cox C, Brinker J, Lima JA (2008) Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med 359(22):2324–2336PubMedCrossRefGoogle Scholar
  53. Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, Lippolis NJ, Berman DS, Callister TQ (2007) Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 50(12):1161–1170PubMedCrossRefGoogle Scholar
  54. Min JK, Kang N, Shaw LJ, Devereux RB, Robinson M, Lin F, Legorreta AP, Gilmore A (2008a) Costs and clinical outcomes after coronary multidetector CT angiography in patients without known coronary artery disease: comparison to myocardial perfusion SPECT. Radiology 249(1):62–70PubMedCrossRefGoogle Scholar
  55. Min JK, Shaw LJ, Berman DS, Gilmore A, Kang N (2008b) Costs and clinical outcomes in individuals without known coronary artery disease undergoing coronary computed tomographic angiography from an analysis of Medicare category III transaction codes. Am J Cardiol 102(6):672–678PubMedCrossRefGoogle Scholar
  56. Min JK, Gilmore A, Budoff MJ, Berman DS, O’Day K (2010) Cost-effectiveness of coronary CT angiography versus myocardial perfusion SPECT for evaluation of patients with chest pain and no known coronary artery disease. Radiology 254(3):801–808PubMedCrossRefGoogle Scholar
  57. Min JK, Dunning A, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Cheng V, Chinnaiyan K, Chow BJ, Delago A, Hadamitzky M, Hausleiter J, Kaufmann P, Maffei E, Raff G, Shaw LJ, Villines T, Berman DS (2011) Age- and Sex-Related Differences in All-Cause Mortality Risk Based on Coronary Computed Tomography Angiography Findings Results From the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 Patients Without Known Coronary Artery Disease. J Am Coll Cardiol 58(8):849–860PubMedCrossRefGoogle Scholar
  58. Motoyama S, Sarai M, Harigaya H, Anno H, Inoue K, Hara T, Naruse H, Ishii J, Hishida H, Wong ND, Virmani R, Kondo T, Ozaki Y, Narula J (2009) Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol 54(1):49–57PubMedCrossRefGoogle Scholar
  59. Mowatt G, Cook JA, Hillis GS, Walker S, Fraser C, Jia X, Waugh N (2008) 64-Slice computed tomography angiography in the diagnosis and assessment of coronary artery disease: systematic review and meta-analysis. Heart 94(11):1386–1393PubMedCrossRefGoogle Scholar
  60. Nance JW Jr, Bamberg F, Schoepf UJ, Kang DK, Barraza JM Jr, Abro JA, Bastarrika G, Headden GF, Costello P, Thilo C (2011) Coronary atherosclerosis in African American and white patients with acute chest pain: characterization with coronary CT angiography. Radiology 260(2):373–380PubMedCrossRefGoogle Scholar
  61. Nance JW Jr, Schlett CL, Schoepf UJ, Oberoi S, Leisy HB, Barraza JM Jr, Headden GF, Nikolaou K, Bamberg F (2012) Incremental prognostic value of different components of coronary atherosclerotic plaque at cardiac CT angiography beyond coronary calcification in patients with acute chest pain. Radiology 264(3):679–690PubMedCrossRefGoogle Scholar
  62. Nardi P, Pellegrino A, Romagnoli A, Mve Mvondo C, De Propris S, Sperandio M, Versaci F, Simonetti G, Chiariello L (2011) Multidetector computed tomographic coronary angiography as an alternative to conventional coronary angiography in non-coronary surgical patients. J Cardiovasc Surg (Torino) 52(3):429–435Google Scholar
  63. Otero HJ, Steigner ML, Rybicki FJ (2009) The “post-64” era of coronary CT angiography: understanding new technology from physical principles. Radiol Clin North Am 47(1):79–90PubMedCrossRefGoogle Scholar
  64. Patel MR, Bailey SR, Bonow RO, Chambers CE, Chan PS, Dehmer GJ, Kirtane AJ, Samuel Wann L, Parker Ward R, Douglas PS, Patel MR, Bailey SR, Altus P, Barnard DD, Blankenship JC, Casey DE Jr, Dean LS, Fazel R, Gilchrist IC, Kavinsky CJ, Lakoski SG, Le DE, Lesser JR, Levine GN, Mehran R, Russo AM, Sorrentino MJ, Williams MR, Wong JB, Wolk MJ, Bailey SR, Douglas PS, Hendel RC, Kramer CM, Min JK, Patel MR, Shaw L, Stainback RF, Allen JM (2012a) ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, Society of Thoracic Surgeons. J Thorac Cardiovasc Surg 144(1):39–71PubMedCrossRefGoogle Scholar
  65. Patel MR, Dehmer GJ, Hirshfeld JW, Smith PK, Spertus JA, Masoudi FA, Dehmer GJ, Patel MR, Smith PK, Chambers CE, Ferguson TB Jr, Garcia MJ, Grover FL, Holmes DR Jr, Klein LW, Limacher MC, Mack MJ, Malenka DJ, Park MH, Ragosta M 3rd, Ritchie JL, Rose GA, Rosenberg AB, Russo AM, Shemin RJ, Weintraub WS, Wolk MJ, Bailey SR, Douglas PS, Hendel RC, Kramer CM, Min JK, Patel MR, Shaw L, Stainback RF, Allen JM (2012b) ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography. J Thorac Cardiovasc Surg 143(4):780–803PubMedCrossRefGoogle Scholar
  66. Pohle K, Achenbach S, Macneill B, Ropers D, Ferencik M, Moselewski F, Hoffmann U, Brady TJ, Jang IK, Daniel WG (2007) Characterization of non-calcified coronary atherosclerotic plaque by multi-detector row CT: comparison to IVUS. Atherosclerosis 190(1):174–180PubMedCrossRefGoogle Scholar
  67. Raff GL, Abidov A, Achenbach S, Berman DS, Boxt LM, Budoff MJ, Cheng V, DeFrance T, Hellinger JC, Karlsberg RP (2009a) SCCT guidelines for the interpretation and reporting of coronary computed tomographic angiography. J Cardiovasc Comput Tomogr 3(2):122–136PubMedCrossRefGoogle Scholar
  68. Raff GL, Chinnaiyan KM, Share DA, Goraya TY, Kazerooni EA, Moscucci M, Gentry RE, Abidov A (2009b) Radiation dose from cardiac computed tomography before and after implementation of radiation dose-reduction techniques. JAMA 301(22):2340–2348PubMedCrossRefGoogle Scholar
  69. Renker M, Nance JW Jr, Schoepf UJ, O’Brien TX, Zwerner PL, Meyer M, Kerl JM, Bauer RW, Fink C, Vogl TJ, Henzler T (2011) Evaluation of heavily calcified vessels with coronary CT angiography: comparison of iterative and filtered back projection image reconstruction. Radiology 260(2):390–399PubMedCrossRefGoogle Scholar
  70. Roe MT, Harrington RA, Prosper DM, Pieper KS, Bhatt DL, Lincoff AM, Simoons ML, Akkerhuis M, Ohman EM, Kitt MM, Vahanian A, Ruzyllo W, Karsch K, Califf RM, Topol EJ (2000) Clinical and therapeutic profile of patients presenting with acute coronary syndromes who do not have significant coronary artery disease.The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) Trial Investigators. Circulation 102(10):1101–1106PubMedCrossRefGoogle Scholar
  71. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB (2012) Heart disease and stroke statistics–2012 update: a report from the American Heart Association. Circulation 125(1):e2–e220PubMedCrossRefGoogle Scholar
  72. Ropers D, Pohle FK, Kuettner A, Pflederer T, Anders K, Daniel W G, Bautz W, Baum U, Achenbach S (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(22):2334–2341; quiz 2334Google Scholar
  73. Schwarz F, Nance JW Jr, Ruzsics B, Bastarrika G, Sterzik A, Schoepf UJ (2012) Quantification of coronary artery calcium on the basis of dual-energy coronary CT angiography. Radiology 264(3):700–707PubMedCrossRefGoogle Scholar
  74. Seifarth H, Schlett CL, Truong QA, Hoffmann U (2012) Cardiac CT in the emergency department. Cardiol Clin 30(1):117–133PubMedCrossRefGoogle Scholar
  75. Shaw LJ, Iskandrian AE (2004) Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol 11(2):171–185PubMedCrossRefGoogle Scholar
  76. Shaw LJ, Berman DS, Hendel RC, Borges Neto S, Min JK, Callister TQ (2008) Prognosis by coronary computed tomographic angiography: matched comparison with myocardial perfusion single-photon emission computed tomography. J Cardiovasc Comput Tomogr 2(2):93–101PubMedCrossRefGoogle Scholar
  77. Shaw LJ, Min JK, Narula J, Lin F, Bairey-Merz CN, Callister TQ, Berman DS (2010) Sex differences in mortality associated with computed tomographic angiographic measurements of obstructive and nonobstructive coronary artery disease: an exploratory analysis. Circ Cardiovasc Imaging 3(4):473–481PubMedCrossRefGoogle Scholar
  78. Sheth T, Dodd JD, Hoffmann U, Abbara S, Finn A, Gold HK, Brady TJ, Cury RC (2007) Coronary stent assessability by 64 slice multi-detector computed tomography. Catheter Cardiovasc Interv 69(7):933–938PubMedCrossRefGoogle Scholar
  79. Shreibati JB, Baker LC, Hlatky MA (2011) Association of coronary CT angiography or stress testing with subsequent utilization and spending among Medicare beneficiaries. JAMA 306(19):2128–2136PubMedCrossRefGoogle Scholar
  80. Small GR, Yam Y, Chen L, Ahmed O, Al-Mallah M, Berman DS, Cheng VY, Chinnaiyan K, Raff G, Villines TC, Achenbach S, Budoff MJ, Cademartiri F, Callister TQ, Chang HJ, Delago A, Dunning A, Hadamitzky M, Hausleiter J, Kaufmann P, Lin F, Maffei E, Min JK, Shaw LJ, Chow BJ (2011) Prognostic assessment of coronary artery bypass patients with 64-slice computed tomography angiography: anatomical information is incremental to clinical risk prediction. J Am Coll Cardiol 58(23):2389–2395PubMedCrossRefGoogle Scholar
  81. Smith SC Jr, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, Lloyd-Jones DM, Minissian M, Mosca L, Peterson ED, Sacco RL, Spertus J, Stein JH, Taubert KA (2011) AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol 58(23):2432–2446PubMedCrossRefGoogle Scholar
  82. Stein PD, Yaekoub AY, Matta F, Sostman HD (2008) 64-slice CT for diagnosis of coronary artery disease: a systematic review. Am J Med 121(8):715–725PubMedCrossRefGoogle Scholar
  83. Sun Z, Almutairi AM (2010) Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: a meta-analysis. Eur J Radiol 73(2):266–273PubMedCrossRefGoogle Scholar
  84. Sun Z, Ng KH (2012) Diagnostic value of coronary CT angiography with prospective ECG-gating in the diagnosis of coronary artery disease: a systematic review and meta-analysis. Int J Cardiovasc Imaging 28(8):2109–2119Google Scholar
  85. Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, Rubin GD, Kramer CM, Berman D, Brown A, Chaudhry FA, Cury RC, Desai MY, Einstein AJ, Gomes AS, Harrington R, Hoffmann U, Khare R, Lesser J, McGann C, Rosenberg A, Schwartz R, Shelton M, Smetana GW, Smith SC Jr (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(22):1864–1894PubMedCrossRefGoogle Scholar
  86. van Werkhoven JM, Schuijf JD, Gaemperli O, Jukema JW, Boersma E, Wijns W, Stolzmann P, Alkadhi H, Valenta I, Stokkel MP, Kroft LJ, de Roos A, Pundziute G, Scholte A, van der Wall EE, Kaufmann PA, Bax JJ (2009) Prognostic value of multislice computed tomography and gated single-photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol 53(7):623–632PubMedCrossRefGoogle Scholar
  87. Van Werkhoven JM, Cademartiri F, Seitun S, Maffei E, Palumbo A, Martini C, Tarantini G, Kroft LJ, de Roos A, Weustink AC, Jukema JW, Ardissino D, Mollet NR, Schuijf JD, Bax JJ (2010) Diabetes: prognostic value of CT coronary angiography–comparison with a nondiabetic population. Radiology 256(1):83–92PubMedCrossRefGoogle Scholar
  88. Virmani R, Burke AP, Farb A, Kolodgie FD (2002) Pathology of the unstable plaque. Prog Cardiovasc Dis 44(5):349–356PubMedCrossRefGoogle Scholar
  89. Voros S, Rinehart S, Qian Z, Joshi P, Vazquez G, Fischer C, Belur P, Hulten E, Villines TC (2011a) Coronary atherosclerosis imaging by coronary CT angiography: current status, correlation with intravascular interrogation and meta-analysis. JACC Cardiovasc Imaging 4(5):537–548PubMedCrossRefGoogle Scholar
  90. Voros S, Rinehart S, Qian Z, Vazquez G, Anderson H, Murrieta L, Wilmer C, Carlson H, Taylor K, Ballard W, Karmpaliotis D, Kalynych A, Brown C 3rd (2011b) Prospective validation of standardized, 3-dimensional, quantitative coronary computed tomographic plaque measurements using radiofrequency backscatter intravascular ultrasound as reference standard in intermediate coronary arterial lesions: results from the ATLANTA (assessment of tissue characteristics, lesion morphology, and hemodynamics by angiography with fractional flow reserve, intravascular ultrasound and virtual histology, and noninvasive computed tomography in atherosclerotic plaques) I study. JACC Cardiovasc Interv 4(2):198–208PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.House Officer, Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins HospitalBaltimoreUSA

Personalised recommendations