SCCT Issues 2021 Expert Consensus Document on Coronary CTA

February 9, 2021—The Society of Cardiovascular Computed Tomography (SCCT) announced the publication of a new expert consensus document on coronary CTA. The society stated that the report addresses current evidence, updates previous recommendations, addresses key questions regarding the use of coronary CTA in multiple different cardiac scenarios, and brings together the collective body of literature in the form of definitive recommendations.

Jagat Narula, MD; Y. Chandrashekhar, MD; and Harvey S. Hecht, MD, served as co-chairs of the Expert Working Group that produced and published the document in Journal of Cardiovascular Computed Tomography. In the SCCT announcement, Dr. Hecht stated, “There have been many substantial advances in coronary CTA technology and a growing body of evidence for the use of cardiac CT in diagnoses of heart disease, prognostication, and modulating medical and interventional therapy. This expert consensus aims to address recent data and bridge the knowledge gap since the last update of the coronary CTA guidelines.”

According to SCCT, the new recommendations outline the use of CTA as a prognosticating risk tool for stable patients with chest pain, while recognizing it is lacking in specificity and positive predictive accuracy, which has led to the development of value-added CTA strategies like fractional flow reserve derived from CT and CT perfusion. These newer technologies arrived in the clinical arena since the publication of the last guidelines and have produced a large volume of data showing significant clinical value.

The consensus document includes recommendations for the following:

• Evaluation of stable coronary artery disease: coronary CTA in native vessels
• Evaluation of stable coronary artery disease: coronary CTA postrevascularization
• Evaluation of stable coronary artery disease: coronary CTA with fractional flow reserve or CT perfusion
• Evaluation of stable coronary artery disease: coronary CTA in other conditions
• Reporting on CTA: coronary and noncoronary information