Canadian Association of Radiologists: Consensus Guidelines and Standards for Cardiac CT

Invasive coronary angiography remains the gold standard for imaging of the coronary arteries. Because of poor temporal and spatial resolution, noninvasive imaging of the heart using computed tomography (CT) had remained a challenge until the recent past. Since 1999, and the advent of 4-detector electrocardiogram (ECG)-gated CT, there have been rapid technical developments in CT technology and postprocessing tools, thus enabling an accurate noninvasive assessment of cardiac anatomy including the coronary arteries as well as cardiac function. Today, this relatively new technique increasingly is being requested and performed on a routine basis. Although guidelines and standards for the performance of cardiac CT (CCT) have been published by other societies outside of Canada [1e5], the Canadian Association of Radiologists recognizes that Canadian radiologists play a leading and pivotal role in the safe and proper implementation of CCT throughout the country, as well as in the training and continuing medical education of physicians performing and interpreting CCT studies. This comprehensive article reviews the current evidence for CCT to date and outlines the standards for the implementation of a CCT program. Based on the review of the current literature and on