RAC Annual Report 2009
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Cardiac CT - Quantitative Evaluation of Coronary Calcification
Clinical Appropriateness Guidelines: Advanced Imaging Appropriate Use Criteria: Imaging of the Heart Effective Date: January 1, 2018 Proprietary Date of Origin: 03/30/2005 Last revised: 11/14/2017 Last reviewed: 11/14/2017 8600 W Bryn Mawr Avenue South Tower - Suite 800 Chicago, IL 60631 P. 773.864.4600 Copyright © 2018. AIM Specialty Health. All Rights Reserved www.aimspecialtyhealth.com Table of Contents Description and Application of the Guidelines ........................................................................3 Administrative Guidelines ........................................................................................................4 Ordering of Multiple Studies ...................................................................................................................................4 Pre-test Requirements ...........................................................................................................................................5 Cardiac Imaging ........................................................................................................................6 Myocardial Perfusion Imaging ................................................................................................................................6 Cardiac Blood Pool Imaging .................................................................................................................................12 Infarct Imaging .....................................................................................................................................................15 -
Assessment of the Coronary Artery in High-Pitch, Dual-Source CT
CARDIAC IMAGING Iran J Radiol. 2017 July; 14(3):e22024. doi: 10.5812/iranjradiol.22024. Published online 2017 July 1. Research Article Assessment of the Coronary Artery in High-Pitch, Dual-Source CT Aortography Without ECG Synchronization Hyeong Gi Choi,1 Mi Jung Park,1,* Ho Cheol Choi,1 Hye Young Choi,1 Hwa Seon Shin,1 Jae Boem Na,1 Jae Min Cho,1 and Dae Seob Choi1 1Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Chilam-Dong, Jinju City, Gyeongnam-Do, Republic of Korea *Corresponding author: Mi Jung Park, MD, Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, 90, Chilam-Dong, Jinju, Gyeongnam-Do, Republic of Korea. Tel: +82-557508814, Fax: +82-557581568, E-mail: [email protected] Received 2016 December 22; Revised 2017 March 17; Accepted 2017 April 01. Abstract Background: The high pitch, dual source computed tomography (CT) provides motion-free aortic imaging. Objectives: To evaluate the image quality of coronary artery using dual-source CT aortography without electrocardiogram (ECG) synchronization. Patients and Methods: One hundred fifty patients (87 men; mean age; 63.7 ± 13.0 years, mean heart rate; 64.7 ± 6.6 beats/min) with suspected or known aortic disease underwent non-ECG gated, high-pitch, dual-source CT aortography. No beta blocker or ni- troglycerin was administered for the patients. The image quality of each coronary artery segment and its ostium was graded on a three-point scale (excellent, moderate, and non-diagnostic image quality). Results: Most patients (88.7%) showed diagnostic image quality in the ostia of the left main and right coronary artery. -
Prevalence of Coronary Artery Disease Evaluated by Coronary CT Angiography in Women with Mammographically Detected Breast Arterial Calcifications
RESEARCH ARTICLE Prevalence of Coronary Artery Disease Evaluated by Coronary CT Angiography in Women with Mammographically Detected Breast Arterial Calcifications Leila Mostafavi1*, Wanda Marfori2, Cesar Arellano1, Alessia Tognolini1, William Speier3, Ali Adibi1, Stefan G. Ruehm1 1 Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America, 2 Department of Radiological Sciences, University of California Irvine, Irvine, CA, United States of America, 3 Medical Imaging Informatics, Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA, United States of America * [email protected] Abstract To assess the correlation between breast arterial calcifications (BAC) on digital mammogra- OPEN ACCESS phy and the extent of coronary artery disease (CAD) diagnosed with dual source coronary Citation: Mostafavi L, Marfori W, Arellano C, computed tomography angiography (CTA) in a population of women both symptomatic and Tognolini A, Speier W, Adibi A, et al. (2015) asymptomatic for coronary artery disease. 100 consecutive women (aged 34 – 86 years) Prevalence of Coronary Artery Disease Evaluated by who underwent both coronary CTA and digital mammography were included in the study. Coronary CT Angiography in Women with Mammographically Detected Breast Arterial Health records were reviewed to determine the presence of cardiovascular risk factors such Calcifications. PLoS ONE 10(4): e0122289. as hypertension, hyperlipidemia, diabetes mellitus, and smoking. Digital mammograms doi:10.1371/journal.pone.0122289 were reviewed for the presence and degree of BAC, graded in terms of severity and extent. Academic Editor: Barry I Hudson, University of Coronary CTAs were reviewed for CAD, graded based on the extent of calcified and non- Miami, UNITED STATES calcified plaque, and the degree of major vessel stenosis. -
ACR Manual on Contrast Media
ACR Manual On Contrast Media 2021 ACR Committee on Drugs and Contrast Media Preface 2 ACR Manual on Contrast Media 2021 ACR Committee on Drugs and Contrast Media © Copyright 2021 American College of Radiology ISBN: 978-1-55903-012-0 TABLE OF CONTENTS Topic Page 1. Preface 1 2. Version History 2 3. Introduction 4 4. Patient Selection and Preparation Strategies Before Contrast 5 Medium Administration 5. Fasting Prior to Intravascular Contrast Media Administration 14 6. Safe Injection of Contrast Media 15 7. Extravasation of Contrast Media 18 8. Allergic-Like And Physiologic Reactions to Intravascular 22 Iodinated Contrast Media 9. Contrast Media Warming 29 10. Contrast-Associated Acute Kidney Injury and Contrast 33 Induced Acute Kidney Injury in Adults 11. Metformin 45 12. Contrast Media in Children 48 13. Gastrointestinal (GI) Contrast Media in Adults: Indications and 57 Guidelines 14. ACR–ASNR Position Statement On the Use of Gadolinium 78 Contrast Agents 15. Adverse Reactions To Gadolinium-Based Contrast Media 79 16. Nephrogenic Systemic Fibrosis (NSF) 83 17. Ultrasound Contrast Media 92 18. Treatment of Contrast Reactions 95 19. Administration of Contrast Media to Pregnant or Potentially 97 Pregnant Patients 20. Administration of Contrast Media to Women Who are Breast- 101 Feeding Table 1 – Categories Of Acute Reactions 103 Table 2 – Treatment Of Acute Reactions To Contrast Media In 105 Children Table 3 – Management Of Acute Reactions To Contrast Media In 114 Adults Table 4 – Equipment For Contrast Reaction Kits In Radiology 122 Appendix A – Contrast Media Specifications 124 PREFACE This edition of the ACR Manual on Contrast Media replaces all earlier editions. -
2012-Nia-Clinical-Guidelines-Avmed
2012 NIA Standard Clincal Guidelines AvMed Guidelines for Clinical Review Determination Preamble NIA is committed to the philosophy of supporting safe and effective treatment for patients. The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging. These criteria are designed to guide both providers and reviewers to the most appropriate diagnostic tests based on a patient‘s unique circumstances. In all cases, clinical judgment consistent with the standards of good medical practice will be used when applying the guidelines. Guideline determinations are made based on the information provided at the time of the request. It is expected that medical necessity decisions may change as new information is provided or based on unique aspects of the patient‘s condition. The treating clinician has final authority and responsibility for treatment decisions regarding the care of the patient. Guideline Development Process These medical necessity criteria were developed by NIA for the purpose of making clinical review determinations for requests for diagnostic tests. The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, and cardiology. They were developed following a literature search pertaining to established clinical guidelines and accepted diagnostic imaging practices. All inquiries should be directed to: National Imaging Associates, Inc. 6950 Columbia Gateway Drive Columbia, MD 21046 Attn: NIA Associate Chief Medical Officer 2011 National -
Cardiac PET and PET/CT Imaging
Cardiac PET and PET/CT Imaging M. F. Di Carli and M. J. Lipton, eds. New York, NY: Springer, 2007, 466 pages, $149 Cardiac PET and PET/CT Imaging is a comprehensive, therapy. Chapters 17, 18, and 21 are a must-read for clini- informative, up-to-date, state-of-the-art textbook on newer cal PET, whereas chapters 23 through 26 are informative cardiac imaging technologies and also provides valuable and useful regarding ongoing research and will help one insight into the future of cardiac imaging. The book has 6 keep up with future developments in this evolving field. parts; the first 5 parts or sections are subdivided into several Part 6 comprises multiple case presentations with good chapters that cover a wide spectrum of presently available illustrations and good explanations of image findings, and newer cardiac imaging modalities and future research goals. many are supported with additional relevant correlations or The first 3 parts progress in a systematic and orderly manner, follow-up findings. There are 18 diverse illustrative cases, starting with the basics of PET instrumentation, the princi- including normal study findings, misregistration and atten- ples of PET, PET tracers and radiopharmaceuticals, CT uation correction artifacts, incidental findings, abnormal cardiac anatomy, iodinated contrast agents, radiation safety, high-risk PET/CT scans, myocardial viability, integrated patient preparation, stress protocols, PET and PET/CT pro- myocardial perfusion with assessment of coronary artery tocols, myocardial PET interpretation, and PET quantifica- calcium score, left ventricular function assessment, and CT tion for assessing preclinical coronary artery disease. The coronary angiography. The writing is clear and understand- relative merits of coronary CT angiography and MRI along able; even difficult topics such as physics, radiochemistry, with integrated assessment of myocardial perfusion using and biochemistry are well presented and are understandable coronary angiography and PET/CT for diagnosing and man- with concentrated reading. -
Corrected Coronary Opacification Decrease from Coronary Computed
ORIGINAL ARTICLE Corrected coronary opacification decrease from coronary computed tomography angiography: Validation with quantitative 13N-ammonia positron emission tomography Dominik C. Benz, MD,a Christoph Gra¨ni, MD,a Paola Ferro, MD,a Luis Neumeier,a Michael Messerli, MD,a Mathias Possner, MD,a Olivier F. Clerc, MD,a Catherine Gebhard, MD,a Oliver Gaemperli, MD,a Aju P. Pazhenkottil, MD,a Philipp A. Kaufmann, MD,a and Ronny R. Buechel, MDa a Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland Received Mar 25, 2017; accepted Jun 7, 2017 doi:10.1007/s12350-017-0980-2 Background. To assess the functional relevance of a coronary artery stenosis, corrected coronary opacification (CCO) decrease derived from coronary computed tomography angiography (CCTA) has been proposed. The present study aims at validating CCO decrease with quantitative 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI). Methods and Results. This retrospective study consists of 39 patients who underwent hybrid CCTA/PET-MPI. From CCTA, attenuation in the coronary lumen was measured before and after a stenosis and corrected to the aorta to calculate CCO and its decrease. Relative flow reserve (RFR) was calculated by dividing the stress myocardial blood flow (MBF) of a vessel territory subtended by a stenotic coronary by the stress MBF of the reference territories without stenoses. RFR was abnormal in 11 vessel territories (27%). CCO decrease yielded a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy for prediction of an abnormal RFR of 73%, 70%, 88%, 47%, and 70%, respectively. Conclusions. CCTA-derived CCO decrease has moderate diagnostic accuracy to predict an abnormal RFR in PET-MPI. -
American College of Radiology – Practice Parameter for Cardiac CT
The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve radiologic services to the patient, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields. The American College of Radiology will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each practice parameter and technical standard, representing a policy statement by the College, has undergone a thorough consensus process in which it has been subjected to extensive review and approval. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice parameter and technical standard by those entities not providing these services is not authorized. Revised 2021 (Resolution 45)* ACR–NASCI–SPR PRACTICE PARAMETER FOR THE PERFORMANCE AND INTERPRETATION OF CARDIAC COMPUTED TOMOGRAPHY (CT) PREAMBLE This document is an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. Practice Parameters and Technical Standards are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care1. -
Iodinated Contrast Media Guideline
IODINATED CONTRAST MEDIA GUIDELINE FACULTY OF CLINICAL RADIOLOGY THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF RADIOLOGISTS® Name of document and version: Iodinated Contrast Media Guideline, V2.3 Approved by: Faculty of Clinical Radiology Date of approval: March 2018 Suggested Citation: The Royal Australian and New Zealand College of Radiologists. Iodinated Contrast Media Guideline. Sydney: RANZCR; 2018. ABN 37 000 029 863 Copyright for this publication rests with The Royal Australian and New Zealand College of Radiologists ® The Royal Australian and New Zealand College of Radiologists Level 9, 51 Druitt Street Sydney NSW 2000 Australia Email: [email protected] Website: www.ranzcr.edu.au Telephone: +61 2 9268 9777 Disclaimer: The information provided in this document is of a general nature only and is not intended as a substitute for medical or legal advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Document name Iodinated Contrast Media Guideline Description The Iodinated Contrast Media Guideline is intended to assist The Royal Australian and New Zealand College of Radiologists®, its staff, Fellows, members and other individuals involved in the administration of iodinated contrast media to patients undergoing medical imaging procedures. Created By Standards of Practice and Accreditation Committee Date Created 2011 Maintained By Faculty of Clinical Radiology, Policy and Advocacy Unit Version Number Modifications Made Date Modified 2011 Document published 2.0 Document updated and published April 2016 2.1 Grammatical error corrected in R31 February 2017 2.2 Nitroglycerin dosages corrected in R39 June 2017 2.3 Adrenaline dosage corrected in R56 March 2018 Iodinated Contrast Media Guideline, V2.3 © The Royal Australian and New Zealand College of Radiologists® March 2018 Page 2 of 39 TABLE OF CONTENTS 1. -
Extremely Rare Single Right Coronary Artery, Multidetector Computed
Arch Cardiol Mex 2012;82(2):195-196 www.elsevier.com.mx IMAGE IN CARDIOLOGY Extremely rare single right coronary artery: multidetector com- puted tomography indings Mauro Echavarría-Pinto, Engels Rodríguez-Rodríguez, Enrico Macías, Eric Kimura- Hayama. Department of Radiology. Instituto Nacional de Cardiología Ignacio Chávez. Mexico City, Mexico. Received on September 9, 2011; accepted on December 9, 2011. KAYWORDS Abstract Coronary anomalies; Mul- Coronary anomalies are rare, with a reported prevalence of 1.3% among patients who undergo tidetector computed to- coronary angiography. The great majority of coronary a rtery anomalies are incidental indings mography; Single right and are not clinically signiicant, but in some cases , may be responsible for angina, syncope, coronary artery; Mexico. arrhythmias or even sudden death. In the following case, we describe coronary CT angiography indings of one of the rarest coronary anomalies. Lip ton R-I type single right coronary artery has only been previously reported in very few occasions and has been seen in only 0.0007% of the population. PALABRAS CLAVE Arteria coronaria derecha única muy infrecuente: hallazgos por tomografía computada Anomalías coronarias; To- multidetector mografía computada mul- ticorte; Arteria coronaria Resumen derecha única; México. Las anomalías congénitas de las arterias coronarias son raras, con una prevalencia estimada de 1.3% en pacientes sometidos a angiografía coronaria. La gran mayoría de estas anomalías no son clínicamente signiicativas, aunque en algunos casos, pueden producir angina, sínco- pe, arritmias e incluso muerte súbita. En el siguiente caso, describimos mediante tomografía computarizada multicorte, una de las anomalías congénitas de las arterias coronarias más raras. La arteria coronaria derecha única tipo R-Ie dLipton, de la que sólo se han reportado muy pocos casos y su prevalencia se estima en 0.0007%. -
High-Pitch Versus Conventional Cardiovascular CT in Patients Being Assessed for Transcatheter Aortic Valve Implantation: a Real-World Appraisal
Open Access Aortic and vascular disease Open Heart: first published as 10.1136/openhrt-2017-000626 on 8 August 2017. Downloaded from High-pitch versus conventional cardiovascular CT in patients being assessed for transcatheter aortic valve implantation: a real-world appraisal Tevfik F Ismail,1 Emma Cheasty,2 Laurence King,3 Sahar Naaseri,2 Olga Lazoura,2 Natalie Gartland,2 Simon Padley,2,4 Michael B Rubens,2,4 Isabel Castellano,3,4 Edward D Nicol2,4 To cite: Ismail TF, Cheasty E, ABSTRACT KEY QUESTIONS King L, et al. High-pitch versus Objective High-pitch protocols are increasingly used in conventional cardiovascular cardiovascular CT assessment for transcatheter aortic CT in patients being assessed What is already known about this subject? valve implantation (TAVI), but the impact on diagnostic for transcatheter aortic Gated cardiovascular CT can be used to evaluate image quality is not known. valve implantation: a real- the aorta and the coronary arteries in patients being Methods We reviewed 95 consecutive TAVI studies: 44 world appraisal. Open Heart considered for transcatheter aortic valve implantation. (46%) high-pitch and 51 (54%) standard-pitch. Single 2017;4:e000626. doi:10.1136/ It is not known whether newer high-pitch acquisition openhrt-2017-000626 high-pitch scans were performed regardless of heart protocols perform as well as standard-pitch rate. For standard-pitch acquisitions, a separate CT- approaches for coronary and aortic evaluation. aortogram and CT-coronary angiogram were performed TI and EC contributed equally with prospective gating, unless heart rate was ≥70 beats/ and are joint first author What does this study add? min, when retrospective gating was used. -
Procedure Request Form
EAST HIXSON DOWNTOWN OOLTEWAH DALTON CLEVELAND 1710 GUNBARREL RD. 2070 HAMILL RD. 440 N. HOLTZCLAW AVE. 9368 BRADMORE LANE 1502 N. THORNTON AVE. 2253 CHAMBLISS AVE. N.W. CHATTANOOGA, TN 37421 HIXSON, TN 37343 CHATTANOOGA, TN 37404 OOLTEWAH, TN 37363 DALTON, GA 30720 SUITE 102 CLEVELAND, TN 37311 Phone: 423.553.1234 Fax: 423.553.1235 Patient’s Name _________________________________ Date of Birth _____________ Appointment Date ____________ Time ___________ Patient Email ______________________________________________________________________________________________________ Procedure Requested (If not listed below) ________________________________________________________________________________ Diagnosis __________________________________________________________________________________________________________ Special Instructions ______________________________________________________________________________________________________ Ordering Physician ________________________________ Physician’s Signature________________________________________ Please Print Report: q ROUTINE q URGENT q STAT Call STAT report to ___________________________ at phone # ____________________ at FAX# ____________________ Perform ASAP Call Results Name After hours/direct phone number Critical result findings will be called to referring providers per CI policy. PET/CT SCAN ULTRASOUND q Brain q Body q ABI MRI q Thyroid Contrast at Radiologist discretion unless otherwise indicated q Retroperitoneal (to include aorta, pancreas, kidneys, bladder) q Brain w/3D Reconstruction