Survey regarding the clinical practice of cardiac CT in Germany: indications, scanning technique and reporting.
OBJECTIVE
To obtain an overview of the current clinical practice of cardiac computed tomography (CT) in Germany.


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.


CONCLUSIONS
Cardiac CT has rapidly become an established procedure with standards regarding indications, scanning technique, and reporting.
Maurer
M H
MH
Institut für Radiologie, Charité - Universitätsmedizin Berlin, Germany.
Hamm
B
B
Dewey
M
M
D000319:Adrenergic beta-Antagonists; D000784:Aortic Dissection / Q000000981:diagnostic imaging; D015906:Angioplasty, Balloon, Coronary; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging; D055424:Cardiac-Gated Imaging Techniques / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy; D003625:Data Collection; D005858:Germany; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005996:Nitroglycerin; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D015607:Stents; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data; D014665:Vasodilator Agents
D000319:Adrenergic beta-Antagonists; D014665:Vasodilator Agents; D005996:Nitroglycerin