Horizon Scanning Technology Summary. Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease
|
|
- Madlyn Elliott
- 5 years ago
- Views:
Transcription
1 Horizon Scanning Technology Summary National Horizon Scanning Centre Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease April 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive statement on the safety, efficacy or effectiveness of the health technology covered and should not be used for commercial purposes.
2 Magnetic resonance angiography (MRA) imaging for the detection of coronary artery disease Target group Diagnosis of coronary artery disease (CAD) in patients with chest pain syndrome a who have an intermediate pre-test probability of CAD and an uninterpretable electrocardiogram (ECG) and/or are unable to exercise. Technology description Magnetic resonance imaging (MRI) is a non-invasive, x-ray free imaging technique in which the patient is exposed to radiofrequency waves in a strong magnetic field, and the pattern of electromagnetic energy released in response is detected and analysed by a computer to generate detailed visual images. Cardiovascular magnetic resonance imaging (CMR) b is an application of MRI that is already used for the evaluation of a range of cardiac parameters, such as cardiac viability, ventricular function and myocardial perfusion and mass. CMR takes around minutes to perform. It cannot be used in patients with metallic implants such as pacemakers or stents. Claustrophobia during the procedure may be problematic in around 2% of patients. 1 It is also difficult to perform in patients with irregular cardiac rhythms or who cannot breath-hold for seconds. Coronary magnetic resonance angiography (MRA) is a specific anatomical application of CMR imaging technology that is currently in development for the non-invasive detection of coronary artery disease (CAD) through the visualisation of coronary artery stenosis. Innovation and/or advantages MRA uses no radiation, does not require the use of contrast media, and is less invasive, cheaper, and safer than standard invasive coronary angiography for the detection of CAD. Place of use Home care e.g. home dialysis Secondary care e.g. general, non-specialist hospital General public e.g. over the counter Community or residential care e.g. district nurses, physio Tertiary care e.g. highly specialist services or hospital Other: Primary care e.g. used by GPs or practice nurses Emergency care Availability, launch or marketing dates, and licensing plans: CMR technology is available in the UK and is already used extensively for the study of peripheral vasculature (including aortography), renal and carotid arteries to exclude stenosis. However, coronary MRA technology requires additional specific software sequences on scanners capable of fast image acquisition, which are not widely available or used. NHS or Government priority area: Cancer Cardiovascular disease Children Diabetes Chronic conditions Mental health Older people Public health Renal disease Women s health None identified Other: a Chest pain syndrome: e.g. chest pain, chest tightness, burning, dyspnea, shoulder pain, and jaw pain. b Also known as cardiac magnetic resonance imaging (CMR). April
3 This topic relates to the National Service Framework for coronary heart disease. Relevant guidance British Cardiovascular Society working group report on the role of non-invasive imaging in the management of coronary artery disease European Society of Cardiology and the Society for Cardiovascular Magnetic Resonance consensus panel report. Clinical indications for cardiovascular magnetic resonance (CMR) European Society of Cardiology. Guidelines for percutaneous coronary interventions American College of Radiology. Practice guideline for the performance and interpretation of paediatric and adult body magnetic resonance angiography (MRA) American College of Cardiology Foundation. Appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging American College of Radiology. Practice guideline for the performance and interpretation of cardiac magnetic resonance imaging (MRI) American College of Cardiology/American Heart Association/American College of Physicians. Clinical competence statement on cardiac imaging with computed tomography and magnetic resonance Clinical need and burden of disease CAD is the leading cause of mortality in the UK, causing 88,271 deaths in England and Wales in 2005, 9 and costing the UK economy over 1.7 billion per annum. Around 201,000 invasive coronary angiographies (ICAs) were performed in the UK in 2004 (excluding percutaneous coronary interventions). 2 Estimates of the number of catheterisations that prove to be negative vary: a US study has suggested 25-50%, 10 while a UK expert suggests 14-20%. Within five years there are predicted to be around 350,000 ICAs performed annually. 2 National catheter laboratory facilities have been expanded in recent years, with 90 new laboratories funded by New Opportunities Funding since However, for patients considered to be at intermediate risk of having high-grade coronary artery stenosis, an accurate and non-invasive means of evaluating CAD would be desirable. A UK expert estimates the pre-test probability distribution for CAD as: Intermediate risk 40% Low risk or normal 30% High risk 30% Existing comparators and treatments Conventional invasive coronary angiography (ICA) involves coronary catheterisation, and is the reference standard for the evaluation of coronary artery stenosis, in-stent stenosis, and the patency of coronary artery bypass grafts. ICA is costly, invasive, and carries a small risk of serious complications (associated mortality 0.07%; low arterial risk <0.25% 2 ). It takes an average of minutes. Multidetector computed tomography angiography (MDCTA). A major emerging imaging modality that is non-invasive and provides superior spatial resolution, but April
4 involves exposure to a radiation dose equivalent to that of diagnostic ICA, and an iodinated intravenous contrast agent. A major limiting factor for the accuracy of MDCTA is its ability to visualise coronary arteries with significant calcification. Electron beam computed tomography (EBCT). An emerging technology that is noninvasive, uses less radiation than MDCTA, but is inferior to both MRA and MDCTA in terms of power and slice thickness. EBCT has largely ceded to MDCTA, and is not currently under commercial development. Efficacy and safety Title Status Published Design Meta-analysis Description of study Primary outcome Secondary outcome Key results Comparative diagnostic performance of MRA and MDCTA for non-invasive angiography Studies published in full and in English between Jan 1990 and Jan 2005 on the detection of significant coronary artery stenoses ( 50% diameter) were identified by (i) Medline search, (ii) manual search of leading cardiology and radiology journals, and (iii) reference lists from cited articles. N=52 studies identified: (a) MRA vs ICA 28 studies (903 patients) (b) MDCTA vs ICA 24 studies using 4, 8 and 16-slice machines (1,300 patients) Intervention: evaluation of stenosis by MRA or MDCTA Comparator: conventional invasive coronary angiography (ICA) Patient group: patients with known or suspected coronary artery disease Diagnostic accuracy: sensitivity and specificity. Pooled analysis based on weighted means (i.e. proportional to the sample size of each individual study). Odds ratio and summary odds ratio compared against ICA. Average % of assessable coronary segments (i.e. those with diagnostic imaging quality). Sensitivity Specificity % of assessable % (95% CI) % (95% CI) coronary segments MRA 72% (69%-75%) 87% (86%-88%) 83% MDCTA 85% (83%-87%) 95% (95%) 87% (4-16 slice CT) 96% (16-slice only) MDCTA was significantly more accurate than MRA in detecting CAD compared to ICA. A combined analysis of the odds ratios showed that for MDCTA, there was a 16.9-fold increased probability of significant CAD found at cardiac catheterisation (ICA), which was significantly higher (p<0.0001) than the 6.4-fold increase found for MRA. Estimated cost and cost impact The precise costs of MRA are difficult to identify as it is usually conducted as part of a conventional MRI examination (adding around 15 minutes to the procedure time), although a UK expert estimates that two-stage MRA may have a tariff at around 200 per case. The 2007/08 NHS tariff for ICA is 1, April
5 Potential or intended impact speculative The 2007 working group report of the British Cardiovascular Society 2 on the role of noninvasive imaging for CAD concluded that although MRA is unlikely to replace diagnostic ICA due to its inferior spatial resolution, the full implementation of CMR could reduce the need for ICAs by up to 25% over the next 10 years. The working group recommended that all new MRI scanners should be CMR-capable and that the current number of 140 CMR scanners will need to be increased over the next 5-10 years. The majority of MRI scanners are currently based in hospital radiology departments, where there are numerous competing demands from other specialties. Issues of access may affect the UK diffusion of this technology for applications in cardiology. In addition, echocardiography, nuclear cardiology and diagnostic cardiac angiography have mainly been performed by cardiologists rather than radiologists. Patients Reduced morbidity Reduced mortality or increased survival (reduced short-term risk from the procedure) Earlier identification of disease Quicker or more accurate diagnosis Other: faster, safer, and less invasive procedure than the current standard (ICA) Improved quality of life for patients and/or carers Changed pathway of care or outcome Services Increased use e.g. length of stay, out-patient visits Service reorganisation required Staff training required Decreased use - reduced demand for the services of specialist laboratories for diagnostic ICA Costs Increased unit cost compared to alternative Savings: cheaper and faster alternative to diagnostic ICA References Increased costs: more patients coming for treatment Other: staff training needed Increased costs: capital investment needed 1 Francis JM & Pennell DJ. The treatment of claustrophobia during cardiovascular magnetic resonance; use and effectiveness of mild sedation. J Cardiovasc Magn Reson 2000; 2: Gershlick A H, de Belder M, Chambers J et al. The role of non-invasive imaging in the management of coronary artery disease current status and future impact. A report from the British Cardiovascular Society working group. Heart 2007; 93: European Society of Cardiology and the Society of Cardiovascular Magnetic Resonance consensus panel report. Clinical indications for cardiovascular magnetic resonance (CMR). Eur Heart J 2004; 25: European Society of Cardiology. Guidelines for percutaneous coronary interventions. Eur Heart J 2005; 26: American College of Radiology. Practice guideline for the performance and interpretation of pediatric and adult body magnetic resonance angiography. 25/02/ Appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. American College of Cardiology Foundation (ACCF) in conjunction with American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am College Cardiol 2006; 48: American College of Radiology. Practice guideline for the performance and interpretation of cardiac magnetic resonance imaging. 10/01/ April
6 8 American College of Cardiology/American Heart Association/American College of Physicians. Clinical competence statement on cardiac imaging with computed tomography and magnetic resonance. J Am College Cardiol 2005; 46: British Heart Foundation mortality data for ICD code I20-25 ischemic heart diseases (2005), available at 10 Poon M. CTA: watershed, soon to be a flood. Article published by Wiley 2005, available at 11 Schujf J D, Bax J J, Shaw L J et al. Meta-analysis of comparative diagnostic performance of magnetic resonance imaging and multislice computed tomography for noninvasive coronary angiography. Am Heart J 2006; 151: NHS tariff for Health Care Resource groups (HRG) code E14 for The National Horizon Scanning Centre is a constituent of the NHS National Institute for Health Research and is managed under contract from the Department of Health's R&D Division. The views expressed in NHSC publications are those of the author(s). They are not necessarily shared by the Department of Health and should not be taken as representing Government policy. The National Horizon Scanning Centre, Department of Public Health and Epidemiology University of Birmingham, Edgbaston, Birmingham, B15 2TT, England Tel: +44 (0) Fax +44 (0) April
Horizon Scanning Technology Summary. Temozolomide (Temodal) for advanced metastatic melanoma. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Temozolomide (Temodal) for advanced metastatic melanoma April 2007 This technology summary is based on information available at the
More informationNoninvasive cardiac imaging refers
CARDIOLOGY PATIENT PAGE Introduction to Noninvasive Cardiac Imaging Ron Blankstein, MD Noninvasive cardiac imaging refers to a combination of methods that can be used to obtain images related to the structure
More informationHorizon Scanning Technology Briefing National Helical Tomotherapy Horizon Hi-ART System for Scanning external cancer Centre radiotherapy August 2006
Horizon Scanning Technology Briefing National Horizon Scanning Centre Helical Tomotherapy Hi-ART System for external cancer radiotherapy August 2006 This technology briefing is based on information available
More informationHorizon Scanning Technology Summary. Methylnaltrexone for opioid induced constipation in advanced illness and palliative care
Horizon Scanning Technology Summary National Horizon Scanning Centre Methylnaltrexone for opioid induced constipation in advanced illness and palliative care April 2007 This technology summary is based
More informationHorizon Scanning Technology Summary. Cyanocobalamin nasal spray (Nascobal) for vitamin B12 deficiency. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Cyanocobalamin nasal spray (Nascobal) for vitamin B12 deficiency April 2007 This technology summary is based on information available
More informationNational Horizon Scanning Centre. Dronedarone (Multaq) for atrial fibrillation and atrial flutter. December 2007
Dronedarone (Multaq) for atrial fibrillation and atrial flutter December 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not
More informationHorizon Scanning Technology Briefing. Magnetic resonance spectroscopy for prostate cancer. National Horizon Scanning Centre.
Horizon Scanning Technology Briefing National Horizon Scanning Centre Magnetic resonance spectroscopy for prostate cancer August 2006 This technology briefing is based on information available at the time
More informationNational Horizon Scanning Centre. Irbesartan (Aprovel) for heart failure with preserved systolic function. August 2008
Irbesartan (Aprovel) for heart failure with preserved systolic function August 2008 This technology summary is based on information available at the time of research and a limited literature search. It
More informationHorizon Scanning Technology Briefing. Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer
Horizon Scanning Technology Briefing National Horizon Scanning Centre Prostate cancer gene 3 (Progensa PCA3) assay in the diagnosis of prostate cancer December 2006 This technology summary is based on
More informationGeneral Cardiovascular Magnetic Resonance Imaging
2 General Cardiovascular Magnetic Resonance Imaging 19 Peter G. Danias, Cardiovascular MRI: 150 Multiple-Choice Questions and Answers Humana Press 2008 20 Cardiovascular MRI: 150 Multiple-Choice Questions
More informationb. To facilitate the management decision of a patient with an equivocal stress test.
National Imaging Associates, Inc. Clinical guidelines EBCT HEART CT & HEART CT CONGENITAL CCTA CPT4 Codes: 75571 EBCT 75572, 75573 Heart CT & Heart CT Congenital 75574 - CCTA LCD ID Number: L33559 J K
More informationHorizon Scanning Technology Summary. Adalimumab (Humira) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Adalimumab (Humira) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationHorizon Scanning Technology Summary. Liraglutide for type 2 diabetes. National Horizon Scanning Centre. April 2007
Horizon Scanning Technology Summary National Horizon Scanning Centre Liraglutide for type 2 diabetes April 2007 This technology summary is based on information available at the time of research and a limited
More informationHorizon Scanning Technology Summary. Abatacept (Orencia) for juvenile idiopathic arthritis. National Horizon Scanning Centre.
Horizon Scanning Technology Summary National Horizon Scanning Centre Abatacept (Orencia) for juvenile idiopathic arthritis June 2007 This technology summary is based on information available at the time
More informationROLE OF MULTISLICE COMPUTED TOMOGRAPHY IN CARDIAC IMAGING
ROLE OF MULTISLICE COMPUTED TOMOGRAPHY IN CARDIAC IMAGING Non-invasive coronary angiography along with multidetector computed tomography or magnetic resonance imaging is attracting increasing interest
More informationThe Final 10-Year Follow-up Results from the Bari Randomized Trial J Am Coll Cardiol (2007) 49;1600-6
The Final 10-Year Follow-up Results from the Bari Randomized Trial J Am Coll Cardiol (2007) 49;1600-6 n&list_uids=17433949 64-Multislice Detector Computed Tomography Coronary Angiography as Potential Alternative
More informationHorizon Scanning Technology Summary. Tenofovir disoproxil fumarate for hepatitis B. National Horizon Scanning Centre. April 2007
Horizon Scanning Technology Summary National Horizon Scanning Centre Tenofovir disoproxil fumarate for hepatitis B April 2007 This technology summary is based on information available at the time of research
More informationMEDICAL POLICY. Proprietary Information of Excellus Health Plan, Inc. A nonprofit independent licensee of the BlueCross BlueShield Association
MEDICAL POLICY SUBJECT: CARDIAC COMPUTED TOMOGRAPHIC PAGE: 1 OF: 7 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical
More informationHorizon Scanning Technology Briefing. Cetuximab (Erbitux) for metastatic colorectal cancer. National Horizon Scanning Centre.
Horizon Scanning Technology Briefing National Horizon Scanning Centre Cetuximab (Erbitux) for metastatic colorectal cancer December 2006 This technology summary is based on information available at the
More informationNational Horizon Scanning Centre. Aflibercept (VEGF Trap) for advanced chemo-refractory epithelial ovarian cancer. December 2007
Aflibercept (VEGF Trap) for advanced chemo-refractory epithelial ovarian cancer December 2007 This technology summary is based on information available at the time of research and a limited literature
More informationNational Horizon Scanning Centre. Tadalafil for pulmonary arterial hypertension. October 2007
Tadalafil for pulmonary arterial hypertension October 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a
More informationNational Horizon Scanning Centre. Ampligen for chronic fatigue syndrome. December 2007
Ampligen for chronic fatigue syndrome December 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive
More informationCardiac Imaging Tests
Cardiac Imaging Tests http://www.medpagetoday.com/upload/2010/11/15/23347.jpg Standard imaging tests include echocardiography, chest x-ray, CT, MRI, and various radionuclide techniques. Standard CT and
More informationMEDICAL POLICY. Proprietary Information of YourCare Health Plan
TOMOGRAPHIC ANGIOGRAPHY (CARDIAC CTA): CONTRAST- MEDICAL POLICY PAGE: 1 OF: 7 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such
More informationRadiology. General radiology department. X-ray
The radiology directorate provides a diagnostic, interventional and therapeutic service for its local population, and a tertiary service for the region. It also provides support to some national work such
More informationPerspectives of new imaging techniques for patients with known or suspected coronary artery disease
Perspectives of new imaging techniques for patients with known or suspected coronary artery disease Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands Correspondence: Jeroen
More informationI have no financial disclosures
Manpreet Singh MD I have no financial disclosures Exercise Treadmill Bicycle Functional capacity assessment Well validated prognostic value Ischemic assessment ECG changes ST segments Arrhythmias Hemodynamic
More informationNational Horizon Scanning Centre. Erlotinib (Tarceva) in combination with bevacizumab for advanced or metastatic non-small cell lung cancer
Erlotinib (Tarceva) in combination with bevacizumab for advanced or metastatic non-small cell lung cancer This technology summary is based on information available at the time of research and a limited
More informationNational Horizon Scanning Centre. Vandetanib (Zactima) for locally advanced or metastatic medullary thyroid cancer. December 2007
Vandetanib (Zactima) for locally advanced or metastatic medullary thyroid cancer December 2007 This technology summary is based on information available at the time of research and a limited literature
More informationHorizon Scanning Technology Briefing. Alvimopan (Entrareg ) for opioid-induced bowel disfunction. National Horizon Scanning Centre.
Horizon Scanning Technology Briefing National Horizon Scanning Centre Alvimopan (Entrareg ) for opioid-induced bowel disfunction August 2006 This technology briefing is based on information available at
More informationMEDICAL POLICY. Proprietary Information of Excellus Health Plan, Inc. A nonprofit independent licensee of the BlueCross BlueShield Association
MEDICAL POLICY SUBJECT: CARDIAC/CORONARY COMPUTED TOMOGRAPHIC ANGIOGRAPHY PAGE: 1 OF: 6 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial
More informationNational Horizon Scanning Centre. Azacitidine (Vidaza) for myelodysplastic syndrome. September 2007
Azacitidine (Vidaza) for myelodysplastic syndrome September 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to
More informationNational Horizon Scanning Centre. Bevacizumab (Avastin) in combination with non-taxanes for metastatic breast cancer - first line therapy
Bevacizumab (Avastin) in combination with non-taxanes for metastatic breast cancer - first line therapy December 2007 This technology summary is based on information available at the time of research and
More informationNational Horizon Scanning Centre. Irbesartan (Aprovel) for prevention of cardiovascular complications in patients with persistent atrial fibrillation
Irbesartan (Aprovel) for prevention of cardiovascular complications in patients with persistent atrial fibrillation August 2008 This technology summary is based on information available at the time of
More informationCardiac MRI in ACHD What We. ACHD Patients
Cardiac MRI in ACHD What We Have Learned to Apply to ACHD Patients Faris Al Mousily, MBChB, FAAC, FACC Consultant, Pediatric Cardiology, KFSH&RC/Jeddah Adjunct Faculty, Division of Pediatric Cardiology
More informationNational Horizon Scanning Centre. Rituximab (MabThera) for chronic lymphocytic leukaemia. September 2007
Rituximab (MabThera) for chronic lymphocytic leukaemia This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive
More informationHorizon Scanning Technology Briefing. Sutent (Sunitinib) for first-line and adjuvant treatment of renal cell carcinoma
Horizon Scanning Technology Briefing National Horizon Scanning Centre Sutent (Sunitinib) for first-line and adjuvant treatment of renal cell carcinoma August 2006: Updated October 2006 This technology
More informationDiagnostic and Prognostic Value of Coronary Ca Score
Diagnostic and Prognostic Value of Coronary Ca Score Dr. Ghormallah Alzahrani Cardiac imaging division, Adult Cardiology department Prince Sultan Cardiac Center ( PSCC) Madina, June 2 Coronary Calcium
More informationCardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures?
Keenan Research Centre Li Ka Shing Knowledge Institute Cardiology for the Practitioner Advanced Cardiac Imaging: Worth the pretty pictures? Howard Leong-Poi, MD, FRCPC Associate Professor of Medicine St.
More informationCovered Indications. Evaluation of chest pain syndrome uninterpretable or equivocal stress test (exercise, perfusion, or stress echo)
BCBS Plans Covered Indications Policy No. 230, Cardiac Computed Tomography, Cardiac Computed Tomography Angiography (CPT 75574, 75573,75572) Last reviewed January 2017 Cardiac Computed Tomography (CCT),
More informationMEDICAL POLICY SUBJECT: CORONARY CALCIUM SCORING
MEDICAL POLICY PAGE: 1 OF: 5 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.
More informationNon Invasive Diagnostic Modalities for Coronary Artery Disease. Dr. Amitesh Aggarwal
Non Invasive Diagnostic Modalities for Coronary Artery Disease Dr. Amitesh Aggarwal Ebers papyrus, ca. 1555 BCE If thou examine a man for illness in his cardia, and he has pains in his arms, in his breasts
More informationNational Horizon Scanning Centre. Temsirolimus (Torisel) for mantle cell lymphoma - relapsed and/or refractory. January 2008
Temsirolimus (Torisel) for mantle cell lymphoma - relapsed and/or refractory January 2008 This technology summary is based on information available at the time of research and a limited literature search.
More informationChapter 5 Section 1.1. Diagnostic Radiology (Diagnostic Imaging)
Radiology Chapter 5 Section 1.1 Issue Date: March 7, 1986 Authority: 32 CFR 199.4(a), (b)(2)(x), (c)(2)(viii), (e)(14) and 32 CFR 199.6(d)(2) 1.0 CPT 1 PROCEDURE CODES 70010-72292, 73000-76499, 77071-77084,
More informationTITLE: Multi-Slice Computed Tomography Coronary Angiography for Coronary Artery Disease: A Review of the Clinical Effectiveness and Guidelines
TITLE: Multi-Slice Computed Tomography Coronary Angiography for Coronary Artery Disease: A Review of the Clinical Effectiveness and Guidelines DATE: 25 February 2009 CONTEXT AND POLICY ISSUES: Coronary
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Contrast-Enhanced Coronary Computed Tomography Angiography (CCTA) Page 1 of 27 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Contrast-Enhanced Coronary Computed
More informationCurrent and Future Imaging Trends in Risk Stratification for CAD
Current and Future Imaging Trends in Risk Stratification for CAD Brian P. Griffin, MD FACC Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Disclosures: None Introduction
More informationInformation for patients. The Cambridge Heart Clinic. World class private patient cardiology services in partnership with Addenbrooke s Hospital
Information for patients The Cambridge Heart Clinic World class private patient cardiology services in partnership with Addenbrooke s Hospital This information can also be provided in different languages,
More informationMultidetector CT Angiography for the Detection of Left Main Coronary Artery Disease. Rani K. Hasan, M.D. Intro to Clinical Research July 22 nd, 2011
Multidetector CT Angiography for the Detection of Left Main Coronary Artery Disease Rani K. Hasan, M.D. Intro to Clinical Research July 22 nd, 2011 Outline Background Hypothesis Study Population Methodology
More informationHorizon Scanning Technology Briefing. Zoledronic Acid (Aclasta) once yearly treatment for postmenopausal. National Horizon Scanning Centre
Horizon Scanning Technology Briefing National Horizon Scanning Centre Zoledronic Acid (Aclasta) once yearly treatment for postmenopausal osteoporosis December 2006 This technology summary is based on information
More informationCabazitaxel (XRP-6258) for hormone refractory, metastatic prostate cancer second line after docetaxel
Cabazitaxel (XRP-6258) for hormone refractory, metastatic prostate cancer second line after docetaxel April 2009 This technology summary is based on information available at the time of research and a
More informationBritish Cardiac Society. Clinical and laboratory cardiac facilities required in the UK
Page 1 of 15 British Cardiac Society Clinical and laboratory cardiac facilities required in the UK David Hackett Professional Standards & Peer Review Committee December 2004 Summary: Clinical cardiac facilities
More informationSYMPOSIA. Coronary CTA. Indications, Patient Selection, and Clinical Implications
SYMPOSIA Indications, Patient Selection, and Clinical Implications Christian Thilo, MD,* Mark Auler, MD,* Peter Zwerner, MD,w Philip Costello, MD,* and U. Joseph Schoepf, MD* Abstract: Recent technical
More informationChapter 5 Section 1.1
Radiology Chapter 5 Section 1.1 Issue Date: March 7, 1986 Authority: 32 CFR 199.4(a), (b)(2)(x), (c)(2)(viii), (e)(14) and 32 CFR 199.6(d)(2) Copyright: CPT only 2006 American Medical Association (or such
More informationNational Horizon Scanning Centre. Sunitinib (Sutent) for advanced and/or metastatic breast cancer. December 2007
Sunitinib (Sutent) for advanced and/or metastatic breast cancer December 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not
More informationUse of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users
Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users February 1 5, 2011 University of Santo Tomas Hospital Angelo King A-V Auditorium Manila,
More informationNational Horizon Scanning Centre. Oral and inhaled treprostinil for pulmonary arterial hypertension: NYHA class III. April 2008
Oral and inhaled treprostinil for pulmonary arterial hypertension: NYHA class April 2008 This technology summary is based on information available at the time of research and a limited literature search.
More informationComputed Tomography of the Coronary Arteries
Cardiology Update DAVOS 2011 Computed Tomography of the Coronary Arteries Anders Persson M.D., Ph.D Director, Assoc. Professor Center for Medical Image Science and Visualization Linköping University SWEDEN
More informationMultiple Gated Acquisition (MUGA) Scanning
Multiple Gated Acquisition (MUGA) Scanning Dmitry Beyder MPA, CNMT Nuclear Medicine, Radiology Barnes-Jewish Hospital / Washington University St. Louis, MO Disclaimers/Relationships Standard of care research
More informationEvidence-Based Management of CAD: Last Decade Trials and Updated Guidelines
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines Enrico Ferrari, MD Cardiac Surgery Unit Cardiocentro Ticino Foundation Lugano, Switzerland Conflict of Interests No conflict
More informationMEDICAL POLICY No R1 COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY CORONARY ARTERIES (CCTA)
COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY CONARY ARTERIES (CCTA) Effective Date: June 19, 2017 Review Dates: 11/15, 11/16 Date Of Origin: November 11, 2015 Status: Current Summary of Changes Clarifications:
More informationMEDICAL POLICY No R2 COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY CORONARY ARTERIES (CCTA)
COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY CONARY ARTERIES (CCTA) Effective Date: January 1, 2018 Review Dates: 11/15, 11/16, 11/17 Date Of Origin: November 11, 2015 Status: Current Summary of Changes Clarifications:
More informationCT Versus MR for the Runoff
CT Versus MR for the Runoff Robert R. Edelman, M.D. Dept. of Radiology NorthShore University HealthSystem Feinberg School of Medicine, Northwestern University Magnetic Resonance Computed Tomography Radio
More informationNational Horizon Scanning Centre. Enhanced Liver Fibrosis Test (ELF) for evaluating liver fibrosis. June 2008
Enhanced Liver Fibrosis Test (ELF) for evaluating liver fibrosis June 2008 This technology summary is based on information available at the time of research and a limited literature search. It is not intended
More informationHow to investigate (Cardiac) Chest Pain
RCP UPDATE IN MEDICINE 27 th November 2017 How to investigate (Cardiac) Chest Pain Justin Carter Consultant Cardiologist North Tees and Hartlepool NHS Trust The spectrum of coronary disease No Disease
More informationIs computed tomography angiography really useful in. of coronary artery disease?
Is computed tomography angiography really useful in screening patients with high risk of coronary artery disease? Myeong-Ki Hong, M.D. Ph D Professor of Medicine Division of Cardiology, Severance Cardiovascular
More informationCardiac CT Angiography
Cardiac CT Angiography Dr James Chafey, Radiologist Why do we need a better test for C.A.D? 1. CAD is the leading cause of death in the US CAD 31% Cancer 23% Stroke 7% 2. The prevalence of atherosclerosis
More informationDisclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview
GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September Disclosures None relevant to this presentation Mini Pakkal Assistant Professor of Radiology University
More informationSiemens Healthineers Erlangen, August 27, Siemens Healthineers presents imaging for complex, minimally invasive procedures
Press Siemens Healthineers Erlangen, August 27, 2016 ESC 2016 in Rome: Exhibition 4, Booth N200 Siemens Healthineers presents imaging for complex, minimally invasive procedures Integrated imaging portfolio
More informationCardiac Nuclear Medicine
Cardiac Nuclear Medicine What is Cardiac Nuclear Medicine? What are some common uses of the procedure? How should I prepare? What does the equipment look like? How does the procedure work? How is the procedure
More informationADVANCED CARDIOVASCULAR IMAGING. Medical Knowledge. Goals and Objectives PF EF MF LF Aspirational
Medical Knowledge Goals and Objectives PF EF MF LF Aspirational Know the basic principles of magnetic resonance imaging (MRI) including the role of the magnetic fields and gradient coil systems, generation
More informationPhysician Self-referral and Health Care Utilization. Rita F. Redberg, MD, MSc Professor of Medicine UCSF Medical Center
Physician Self-referral and Health Care Utilization Rita F. Redberg, MD, MSc Professor of Medicine UCSF Medical Center Physician self-referral why should we care? Extent of occurrences Impact of physician
More informationRecommended Standards in ECG Gated Cardiac CT Training: British Society of Cardiac Imaging (BSCI)
President: Dr Roger Bury Secretary: Dr Mark Hamilton Treasurer: Dr Giles Roditi www.bsci.org.uk Recommended Standards in ECG Gated Cardiac CT Training: British Society of Cardiac Imaging (BSCI) Background
More informationImaging of the Heart Todd Tessendorf MD FACC
Imaging of the Heart Todd Tessendorf MD FACC Outline Imaging Modalities for Structural Heart Disease ECHO, MRI Imaging Modalities for Ischemic Heart Disease SPECT, PET, CCTA Show lots of pretty pictures
More informationADI Procedure Codes. August 2016 Revised April 2017 Page 1 of 7 ADI Procedure Codes
Code Description 70450 CT Head without contrast 70460 CT Head with contrast 70470 CT Head with & without contrast 70480 CT Orbit, et al without contrast 70481 CT Orbit, et al with contrast 70482 CT Orbit,
More informationNational Horizon Scanning Centre. Methylnaltrexone (MOA-728) for postoperative ileus. April 2008
(MOA-728) for postoperative ileus April 2008 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive statement
More informationNational Horizon Scanning Centre. GV1001 for advanced and/or metastatic pancreatic cancer. April 2008
GV1001 for advanced and/or metastatic pancreatic cancer April 2008 This technology summary is based on information available at the time of research and a limited literature search. It is not intended
More informationCardiac Imaging. Kimberly Delcour, DO, FACC. Mahi Ashwath, MD, FACC, FASE. Director, Cardiac CT. Director, Cardiac MRI
Cardiac Imaging Kimberly Delcour, DO, FACC Director, Cardiac CT Mahi Ashwath, MD, FACC, FASE Director, Cardiac MRI Cardiac Imaging Discuss the clinical applications of and indications for: Cardiac CT Nuclear
More informationDiagnostic Algorithms
Diagnostic Algorithms Udo Sechtem Robert-Bosch-Krankenhaus Stuttgart Germany Montalescot G et al. ESC Guideline on the Management of Stable Coronary Artery Disease Eur Heart J. 2013;34:2949-3003. European
More informationSYNTAX III REVOLUTION Trial Press briefing conference. Prof. Patrick W. Serruys MD, PhD Principal Investigator Imperial College of London
SYNTAX III REVOLUTION Trial Press briefing conference Prof. Patrick W. Serruys MD, PhD Principal Investigator Imperial College of London Title: Coronary Computed Tomography Angiography for Heart Team Decision-making
More informationThe Value of Stress MRI in Evaluation of Myocardial Ischemia
The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction
More informationTechnical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, May 2008 Vienna International Centre
Technical Meeting on: Current Role of Nuclear Cardiology in the Management of Cardiac Diseases Vienna, 5-95 9 May 2008 Vienna International Centre Evidence-based Nuclear Cardiology: Imaging of CAD The
More informationMedical Policy An Independent Licensee of the Blue Cross and Blue Shield Association
CTA for Coronary Artery Evaluation Page 1 of 22 Medical Policy An Independent Licensee of the Blue Cross and Blue Shield Association Title: Contrast-Enhanced Computed Tomography Angiography (CTA) for Coronary
More informationMultimodality Imaging of Anatomy and Function in Coronary Artery Disease. Joanne D. Schuijf
Multimodality Imaging of Anatomy and Function in Coronary Artery Disease Joanne D. Schuijf The research described in this thesis was performed at the departments of Cardiology and Radiology of the Leiden
More informationHybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future
Hybrid cardiac imaging Advantages, limitations, clinical scenarios and perspectives for the future Prof. Juhani Knuuti, MD, FESC Turku, Finland Disclosure: Juhani Knuuti, M.D. Juhani Knuuti, M.D. has financial
More informationGuide to Cardiology Care at Scripps
Guide to Cardiology Care at Scripps Cardiology is the word in health care associated with heart, but the body s vascular system is also an important part of heart care. Your body has more than 60,000 miles
More informationEribulin for locally advanced or metastatic breast cancer third line; monotherapy
Eribulin for locally advanced or metastatic breast cancer third line; monotherapy April 2009 This technology summary is based on information available at the time of research and a limited literature search.
More informationNew Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology
New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor Cardiothoracic Radiology Disclosure I have no disclosure pertinent to this presentation.
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Cardiology
Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011
More informationNational Horizon Scanning Centre. Pregabalin (Lyrica) for fibromyalgia. September 2007
Pregabalin (Lyrica) for fibromyalgia September 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a definitive
More informationCoronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital
Coronary Artery Imaging Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Larger array : cover scan area Detector size : spatial resolution Rotation speed : scan time Retrospective
More informationAtypical pain and normal exercise test
Atypical pain and normal exercise test F. Mut, M. Beretta Nuclear Medicine Service, Asociacion Española Montevideo, Uruguay Clinical history 67-year old male with several coronary risk factors. Atypical
More informationContrast-Enhanced Computed Tomography Angiography (CTA) for Coronary Artery Evaluation
Contrast-Enhanced Computed Tomography Angiography (CTA) for Coronary Artery Evaluation Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary,
More informationEvidence for Everyone: Expanding the Reach of Health Technology Assessment 2016 CADTH Symposium, April 10-12, Shaw Centre, Ottawa
Dr. Ross Davies President Dr. Benjamin Chow Vice-President Dr. Jonathan Leipsic Secretary/Treasurer Office 222 Queen Street Suite 1403 Ottawa, ON K1P 5V9 www.ccs.ca/ nuclear_ct@ccs.ca Evidence for Everyone:
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Efficiency
Quality ID #323: Cardiac Stress Imaging t Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI) National Quality Strategy Domain: Efficiency and Cost Reduction
More informationReview of Cardiac Imaging Modalities in the Renal Patient. George Youssef
Review of Cardiac Imaging Modalities in the Renal Patient George Youssef ECHO Left ventricular hypertrophy (LVH) assessment Diastolic dysfunction Stress ECHO Cardiac CT angiography Echocardiography - positives
More informationPatient referral for elective coronary angiography: challenging the current strategy
Patient referral for elective coronary angiography: challenging the current strategy M. Santos, A. Ferreira, A. P. Sousa, J. Brito, R. Calé, L. Raposo, P. Gonçalves, R. Teles, M. Almeida, M. Mendes Cardiology
More informationPolicy #: 222 Latest Review Date: March 2009
Name of Policy: MRI Phase-Contrast Flow Measurement Policy #: 222 Latest Review Date: March 2009 Category: Radiology Policy Grade: Active Policy but no longer scheduled for regular literature reviews and
More informationDetection Of Functional Significance of Coronary Stenoses Using Dynamic. Values Of Myocardial Blood Flow And Coronary Flow Reserve
The 2nd International Symposium on Physics, Engineering and Technologies for Biomedicine Volume 2018 Conference Paper Detection Of Functional Significance of Coronary Stenoses Using Dynamic 13 N-Ammonia
More informationComputed tomography in coronary imaging: current status
7 Computed tomography in coronary imaging: current status ARJUN NAIR AND ANAND DEVARAJ Recent technological advances have led to improvements in the use of computerised tomography for coronary imaging.
More information