Koya Ozawa MD, Presenter: Nothing to Disclose

Nobusada Funabashi MD, PhD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Takaoka MD, PhD, Abstract Co-Author: Nothing to Disclose

Masae Uehara MD, Abstract Co-Author: Nothing to Disclose

Yoshio Kobayashi, Abstract Co-Author: Nothing to Disclose

Appropriate cardiac CT performance depending upon ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac CT is important. To resolve problems in actual CT performance, we checked appropriateness of CT use in 2003 and 2011 dependent on these criteria.

Retrospective analysis of purpose and content of cardiac CT performance in 218 consecutive subjects (128 male, mean age 63 y) in whom 16-slice CT was performed in 2003 and 301 consecutive subjects (175 male, mean age 62 y) in whom 320-slice CT was performed in 2011 at our institute.

Purposes of CT examination in 2003 and 2011 were 39.0% and 45.2% for detection of coronary artery disease (CAD), 38.1% and 45.2% for evaluation of cardiac structure and function, 19.2% and 6.0% for risk assessment of post revascularization (PR) and 3.7% and 3.6% for risk assessment of preoperative evaluation, respectively. Percentage of appropriateness in all subjects was 55.1% in 2003, which improved to 80.7% in 2011. Percentages of appropriateness of detection of CAD was 42.4% in 2003, which improved to 76.5% in 2011, mainly because of performance in symptomatic subjects in 2011. Percentages of appropriateness of evaluation of cardiac structure and function was 90.4% in 2003, which improved to 100% in 2011, mainly because of inadequate images from other noninvasive modalities in 2011. Percentages of Inappropriateness of risk assessment of PR was 23.8% in 2003, which worsened to 72.2% in 2011, mainly because evaluation of patency of coronary artery bypass graft (CABG) in asymptomatic subjects was frequently performed just after operation in 2011. Percentages of inappropriate and uncertain preoperative evaluation were 62.5% and 37.5% in 2003, which improved to 27.3% and 72.7% in 2011, respectively, mainly because CT was performed before intermediate risk surgery and subjects were restricted to those with functional capacity <4 METs with 1 clinical risk predictors.

Total appropriateness of CT use improved but appropriateness of risk assessment of PR worsened from 2003 to 2011.

Information on appropriateness of risk assessment of PR, especially for CABG, should be given to cardiologists and cardiovascular surgeons.

Ozawa, K, Funabashi, N, Takaoka, H, Uehara, M, Kobayashi, Y, Improvement and Problems in Appropriate Use of Cardiac CT 2003 Use of 16-slice CT and 2011 Use of 320-Slice CT Depending Upon ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac CT.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043717.html