Green light for new generation cardiac CT scanners

PROVISIONAL recommendations in the draft guidance from the UK’s National Institute for Health and Clinical Excellence (NICE) support the use of Somatom Definition Flash CT scanner (Siemens AG Healthcare), Aquilion ONE (Toshiba Medical Systems), Brilliance iCT (Philips Healthcare) and Discovery CT750 (GE Healthcare) in the NHS in England for people with suspected or known coronary artery disease in whom imaging is difficult with earlier generation CT scanners.

People with a calcium score above 400 are considered difficult to image using earlier generation CT technologies. Other reasons that make CT imaging difficult are obesity, arrhythmias (irregular heart beat), high heart rates (above 70 beats per minute) or previous coronary stents or bypass grafts.

The new generation cardiac CT scanners have advanced technical features that can overcome these difficulties. These include the ability to acquire images much faster than earlier generation CT scanners, better image quality and reduced radiation doses.

Draft guidance from NICE’s Diagnostics Assessment Programme recommends the use of new generation CT scanners for first line imaging of the coronary arteries in people with suspected stable coronary artery disease who are difficult to image with earlier generation CT scanners and whose estimated probability of having coronary artery disease is 10-29 per cent. In addition, the draft guidance recommends their use in people with known coronary artery disease for first line evaluation of disease progression to establish the need for revascularisation where imaging with earlier generation CT scanners is difficult. (Source: NICE, www.nice.org.uk)