Indications, imaging technique, and reading of cardiac computed tomography: survey of clinical practice.

OBJECTIVES: To obtain an overview of the current clinical practice of cardiac computed tomography (CT). METHODS: A 32-item questionnaire was mailed to a total of 750 providers of cardiac CT in 57 countries. RESULTS: A total of 169 questionnaires from 38 countries were available for analysis (23%). Most CT systems used (94%, 207/221) were of the latest generation (64-row or dual-source CT). The most common indications for cardiac CT was exclusion of coronary artery disease (97%, 164/169). Most centres used beta blockade (91%, 151/166) and sublingual nitroglycerine (80%, 134/168). A median slice thickness of 0.625 mm with a 0.5-mm increment and an 18-cm reconstruction field of view was used. Interpretation was most often done using source images in orthogonal planes (92%, 155/169). Ninety percent of sites routinely evaluate extracardiac structures on a large (70%) or cardiac field of view (20%). Radiology sites were significantly more interested in jointly performing cardiac CT together with cardiology than cardiologists. The mean examination time was 18.6 ± 8.4 min, and reading took on average 28.7 ± 17.8 min. CONCLUSIONS: Cardiac CT has rapidly become established in clinical practice, and there is emerging consensus regarding indications, conduct of the acquisition, and reading.

Improvement of skills and knowledge by a hands-on cardiac CT course: before and after evaluation with a validated questionnaire and self-assessment.

PURPOSE: Cardiac computed tomography (CT) is becoming increasingly important in noninvasive imaging. To meet this demand, there are a growing number of short training courses for cardiac CT. Whether such courses improve the knowledge and skills of participants is not known. MATERIALS AND METHODS: The concept of a two-day cardiac CT course consisting of introductory lectures, live patient examinations, and hands-on exercises for interpreting cardiac CT scans on workstations was analyzed using participant evaluations (scales from 1=excellent to 6=very poor). Participants rated their increase in knowledge and completed a validated questionnaire with 20 questions. RESULTS: A total of 102 participants attended the courses. There were significant differences in the number of correctly answered test questions between cardiac CT experts and participants at the beginning of the course (91.5+/-6.3 % vs. 62.4+/-16.1% p<0.001). The number of questions answered correctly by the participants increased significantly after completion of the course (mean increase of 4 correctly answered questions, 81.8+/-11.4%. vs. 62.4+/-16.1% p<0.001). This objective increase in knowledge was in good agreement with participant self-assessments (76.4+/-12.6% vs. 81.8+/-11.4%). The quality of the course received good to very good scores, ranging from 1.8+/-0.7 for speed of presentation to 1.4+/-0.5 for lecturer competence. The score for overall course quality was 1.4+/-0.6. CONCLUSION: A relatively short cardiac CT course can significantly improve the quantifiable knowledge of participants. The overall quality of the course was rated as very good.