Self-evaluation of computed tomography use in the diagnosis of coronary artery disease

Congress:

EuroSafe Imaging 2017

Poster Number:

ESI-0044

Type:

EuroSafe Imaging

Keywords:

Diagnostic procedure, CT-Angiography, Cardiac, Action 5 - Performance indicators for radiation protection management, Action 2 - Clinical diagnostic reference levels (DRLs), Action 6 - Clinical audit tool for imaging, Action 9 - Development of criteria for safe imaging procedures, Action 3 - Optimisation, diagnostic reference levels, image quality, Action 2 - Clinical audit, Radiation safety, Dosimetric comparison, Quality assurance

Authors:

J. Hakumäki, J. Vienonen, M. Hedman, P. Saari, H. Matikka, M. Husso, R. Vanninen

DOI:

10.1594/esi2017/ESI-0044

DOI-Link:

https://dx.doi.org/10.1594/esi2017/ESI-0044

Table 1: Table 1. Radiation doses attributed to CCTA techniques.

Fig. 1: Figure 1. Technical success rates of evaluated CCTA techniques.

Background/Introduction

Clinical Audit is a systematic review of the radiological procedures in order to improve the quality and the outcome of patient care1. The Member States are required to implement clinical audits in accordance with national procedures. In 2011, the Finnish Committee for Clinical Audit recommended use of self-evaluation as part of Clinical Audits in areas which are evolving and need special attention. One such area is cardiaccomputed tomography(CT)2 and especially coronary computed tomography angiography (CCTA), where procedures are increasing in number and the radiation doses...

Description of activity and work performed

Study protocol This self-evaluation study assessed all consecutive CCTA procedures during a one-year period (1.2.2015-31.1.2016) at Kuopio University Hospital in Finland. A Siemens Somatom Definition Flash scanner was used for imaging. The research material consisted of 210 patients, two-thirds of which were women and had an average+SD age of 53+10 years and weight of 79+17 kg. Results The status of coronary artery disease was successfully identified with CCTAin 98.6% (n=207) of patients. Altogether 25.6% of the patients (n=54) had signs of atherosclerosis in coronary arteries...

Conclusion and Recommendations

This self-evaluation shows that: CCTA is a feasible tool forevaluating state of coronaryarterydisease in a selected patient material at 98,6% certainty The associated radiation dose is relatively low with the modern Flash technique (one third of conventional gated techniques), which is also technically robust Further imaging (interventional or diagnostic)is rarely needed after CCTA As an addition to external clinical audits, focused self-evaluation is useful for benchmarking and improving clinical practices.

Personal/Organisational information

Information on KUH Diagnostic Imaging Center

References

1.http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex:31997L0043 2.Koo HJ et al. (2016) Int. J. Cardiovasc. Imag. 32: Suppl 1; 1-19. 3.https://www.healthcare.siemens.com/computed-tomography/dual-source-ct/somatom-definition-flash/technical-specifications