CT Angiography and Cardiovascular Disease Characterization

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 24, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 1.50
Patient Care: 0.25
Patient Interactions and Management: 0.25
Procedures: 1.25
Diagnostic and Electrophysiology Procedures: 0.50
Interventional Procedures: 0.75

Computed Tomography: 3.00
Safety: 0.25
Radiation Safety and Dose: 0.25
Image Production: 0.50
Image Formation: 0.25
Image Evaluation and Archiving: 0.25
Procedures: 2.25
Head, Spine, and Musculoskeletal: 0.50
Neck and Chest: 1.50
Abdomen and Pelvis: 0.25

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Musculoskeletal: 0.50

Nuclear Medicine Technology: 0.25
Procedures: 0.25
Cardiac Procedures: 0.25

Registered Radiologist Assistant: 2.50
Safety: 0.25
Patient Safety, Radiation Protection, and Equipment Operation: 0.25
Procedures: 2.25
Thoracic Section: 1.50
Neurological, Vascular, and Lymphatic Sections: 0.75

Vascular-Interventional Radiography: 0.50
Patient Care: 0.25
Patient Interactions and Management: 0.25
Procedures: 0.25
Vascular Interventional Procedures: 0.25

Outline

1. Introduction
2. Emergence of CT Angiography
3. Computers and Image Processing
4. Contributions of CT Angiography to Clinical Practice
5. Acute Aortic Syndromes: New Knowledge Redefining Disease Classification
6. Peripheral Vascular Disease: Pushing the Envelope for CT Angiography Coverage and Visualization
7. Endovascular Aortic Repair
   1. Wave 1: Aortic Endograft Deployment
   2. Wave 2: Transcatheter Aortic Valve Implantation
8. CT Angiography of Coronary Artery Disease: The Final Frontier
   1. Myocardial Perfusion
   2. Estimating Lesion-Specific Ischemia from Resting CT Angiography
9. Concerns for Radiation
10. Summary

Objectives

Upon completion of this course, students will:

1. be familiar with traditional methods for diagnosis and characterization of vascular disease
2. identify the strengths of conventional angiography
3. be familiar with the history and development of MR angiography
4. recognize the significance of the introduction of helical CT
5. identify the limitations of early helical CT systems
6. be familiar with the CT advancements that expanded the clinical application of CT angiography
7. be familiar with multidetector CT technology
8. recognize the current standards for state-of-the-art CT systems
9. understand the application of Moore’s law
10. be familiar with AAS
11. be familiar with intramural hematoma
12. understand the CT advancements that led to reclassification of AAS
13. be familiar with PAU
14. identify the CT FOV for anatomic coverage for adult lower extremity imaging
15. understand the limitations for displaying cardiovascular CT data sets
16. understand the role of MRI angiography
17. identify the commonly used methods for diagnosing PAD in the lower extremity
18. be familiar with the categories of PAD
19. be familiar with the advantages of CT angiography vs. MRI angiography
20. understand the advantages of using dual-energy CT systems
21. be familiar with the introduction of endovascular repair of the aorta
22. identify the demands on preoperative imaging for stent-graft replacement
23. be familiar with the traditional method of sizing an endograft
24. be familiar with the use of MRI to detect endoleaks
25. be familiar with the TAVR procedure
26. identify the researchers responsible for introducing the TAVR approach
27. understand the primary cause of paravalvular regurgitation using the TAVR approach
28. be familiar with the first CT method for performing CT coronary angiography
29. identify the use of ECG-triggering and ECG-gated tube current pulse to lower radiation exposure
30. be familiar with the diagnostic characteristics of CT studies employing a low-radiation-dose technology
31. be familiar with the radiation levels using low-radiation-dose CT techniques
32. understand the role of CT angiography in the ER setting
33. identify the primary concerns limiting the use of CT for routine coronary CT angiography
34. be familiar with the traditional modality for first-line cardiac function assessment
35. understand the performance characteristics of coronary CT angiography
36. be familiar with the emerging strategies for improving the characteristics of coronary CT angiography
37. be familiar with the current limitation of using myocardial attenuation patterns to assess myocardial perfusion
38. compare the advantages of using FFTCT
39. be familiar with radiation concerns due to CT utilization
40. identify the use of iterative reconstruction techniques to lower radiation exposure