Survey regarding the clinical practice of cardiac CT in Germany: indications, scanning technique and reporting

Rofo. 2009 Dec;181(12):1135-43. doi: 10.1055/s-0028-1109621. Epub 2009 Aug 20.

Abstract

Purpose: To obtain an overview of the current clinical practice of cardiac computed tomography (CT) in Germany.

Materials and methods: A 30-item questionnaire was mailed to 149 providers of cardiac CT in Germany. The items asked about indications, scanning technique and reporting, data storage, and cost of the examination.

Results: Overall 45 questionnaires could be analyzed (30 %). The majority of centers (76 %, 34 of 45 centers) used CT scanners of the latest generation (at least 64 rows). The most common appropriate indications were exclusion of coronary artery disease (91 %, 41 / 45), coronary anomalies (80 %, 36 / 45), and follow-up after coronary artery bypass grafting (53 %, 24 / 45). Each center examined on average 243 +/- 310 patients in 2007 and the number of centers performing cardiac CT increased significantly in 2007 (p = 0.035) compared with the preceding year. Most used sublingual nitroglycerin (84 %, 38 / 45; median of 2 sprays = 0.8 mg) and/or a beta blocker (86 %, 39 / 44; median of 5 mg IV, median heart rate threshold: 70 beats/min). Many providers used ECG-triggered tube current modulation (65 %, 29 / 44) and/or adjusted the tube current to the body mass index or body weight (63 %, 28 / 44). A median slice thickness of 0.75 mm with a 0.5 mm increment and a 20 cm field-of-view was most commonly used. Source images in orthogonal planes (96 %, 43 / 45), curved MPRs (93 %, 42 / 45), and thin-slice MIPs (69 %, 31 / 45) were used most frequently for interpretation. Extracardiac structures were also evaluated by 84 % of the centers (38 / 45). The mean examination time was 16.2 min and reporting took an average of 28.8 min.

Conclusion: Cardiac CT has rapidly become an established procedure with standards regarding indications, scanning technique, and reporting.

MeSH terms

  • Adrenergic beta-Antagonists
  • Angioplasty, Balloon, Coronary
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Dissection / diagnostic imaging
  • Cardiac-Gated Imaging Techniques / instrumentation
  • Cardiac-Gated Imaging Techniques / methods
  • Cardiac-Gated Imaging Techniques / statistics & numerical data
  • Coronary Angiography / methods
  • Coronary Artery Bypass
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / therapy
  • Data Collection
  • Germany
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Diseases / diagnostic imaging*
  • Humans
  • Image Processing, Computer-Assisted / instrumentation
  • Image Processing, Computer-Assisted / methods*
  • Image Processing, Computer-Assisted / statistics & numerical data
  • Nitroglycerin
  • Pulmonary Embolism / diagnostic imaging
  • Stents
  • Surveys and Questionnaires
  • Time and Motion Studies
  • Tomography, X-Ray Computed / instrumentation
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / statistics & numerical data
  • Utilization Review / statistics & numerical data
  • Vasodilator Agents

Substances

  • Adrenergic beta-Antagonists
  • Vasodilator Agents
  • Nitroglycerin