title: Current utilization of cardiac computed tomography in mainland China: A national survey.
abstract: BACKGROUND
  Surveys that describe the utilization of cardiac CT are available for the United States, Germany, and Taiwan, but not mainland China.
  
  
  OBJECTIVE
  To analyze the clinical utilization of cardiac CT in mainland China.
  
  
  METHODS
  A 25-item questionnaire was created and 240 tertiary hospitals were randomly selected to participate. Survey data were collected and confirmed by email as well as phone interviews.
  
  
  RESULTS
  In total, 237 (99%) hospitals consented to this survey, but 85 were excluded because of lack of cardiac CT patient volume or advanced technology. Finally, 152 (64%) questionnaires were available for analysis. Median patient volume was 1,037 patients (range: 150-8,072) annually. The most common clinical indications for coronary CT angiography were exclusion of coronary artery disease in patients with low to intermediate pretest likelihood, asymptomatic individuals with cardiovascular risk factors, and follow-up after coronary bypass grafting. The median heart rate threshold for beta blocker administration was >70 beats/min; most centers (86%) used sublingual nitroglycerin. Prospectively ECG triggered acquisition was the predominant technique in 44% of hospitals. Most (59%) providers adjusted the tube current to the body mass, but few (16%) adjusted the contrast injection rate. Per case, the mean examination duration was 14.2 min; post-processing time 13.6 min; and reporting time 18.0 min.
  
  
  CONCLUSIONS
  Cardiac CT is widely established in clinical practice in mainland China but there is a need for more uniform standards regarding performance and clinical utilization.
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Liu
authors.affiliation: Olin Business School, Washington University in St. Louis, 1 Brookings Drive, St. Louis 63130, MO, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hsieh
authors.affiliation: Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao Street, Beijing 100005, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhuang
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Zhennan
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, 167 Beilishi Road, Beijing 100037, China.
authors.forename: Xinshuang
authors.initials: X
authors.lastname: Ren
authors.affiliation: Department of Radiology, PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
authors.forename: Jiayin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, 1124 West Carson Street, Torrance 90502, CA, United States.
authors.forename: Matthew Jay
authors.initials: MJ
authors.lastname: Budoff
authors.affiliation: Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center of Cardiovascular Diseases, 167 Beilishi Road, Beijing 100037, China. Electronic address: blu@vip.sina.com.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
mesh_terms: D055424:Cardiac-Gated Imaging Techniques / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D000069079:Radiation Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014600:Utilization Review
keywords: CT angiography; Computed tomography; Coronary artery; Questionnaire