What is a CT Coronary Angiogram? (CTCA)
A CT Coronary Angiogram (CTCA) is a specialised type of CT scan that produces high-resolution images inside the small blood vessels that supply the heart muscle (the Coronary Arteries). CTCA is a fast, non-invasive test that accurately detects coronary artery plaque and narrowings of the Coronary Arteries (stenoses) that may lead to heart disease or heart attack (myocardial infarction).
Heart disease remains the number one cause of death worldwide in adults over age 50. As has been reported in the media in recent years after the tragic and unexpected passing of several high-profile public figures, Coronary Artery disease may often go undetected until the advanced stages.
Panorama Radiology Specialists has invested in industry-leading 640-slice Cardiac CT technology in our Gold Coast clinic. Utilising Artificial Intelligence image enhancement, it generates the clearest possible images inside the Coronary Arteries using dramatically reduced radiation doses, up to 80% lower than conventional CT machines. Our CT scanner’s 640 slice, 16cm field of view uniquely allows scanning of the entire heart in a fraction of a heartbeat, in around 0.25 of a second (faster than the blink of a human eye at 0.3 seconds).
Just like a camera shutter, faster CTCA acquisition times mean reduced motion blur and sharper image quality inside the Coronary Arteries, which are just 2-3mm wide. Our CT scanner’s ultra-fast scan times also reduce the requirement for pre-scan Beta Blockers, which are commonly used to lower heart rates for CTCA studies.
What Are the Benefits of CT Coronary Angiography?
CT Coronary Angiography (CTCA) rapidly, accurately and non-invasively detects the amount, extent and composition of Coronary Artery plaque (atheroma), and measures the percentage of narrowing of affected vessels.
Unlike CT Coronary Calcium Scoring (CTCS), CTCA detects the presence and severity of Coronary Artery stenosis and also detects high-risk soft plaque, which carries a significantly higher risk of plaque rupture and future major adverse coronary events. (*Source : Circulation: Cardiovascular Imaging, Jan 2018).
CT Coronary Calcium Scoring, on the other hand, simply measures the total volume of calcified plaque in the wall of the Coronary Arteries to give an overall cardiac risk indicator of heart disease.
When mild coronary plaque is detected on CTCA, generally lifestyle modification and preventative steps are recommended, such as quitting smoking or managing risk factors such as high blood pressure, diabetes and high cholesterol. More advanced plaque may warrant preventative and therapeutic medication. In severe Coronary Artery disease causing significant vessel narrowing on CTCA, treating cardiologists may consider interventional procedures such as diagnostic angiography with a potential view to angioplasty (balloon dilatation) or stenting to re-open narrowed vessels, depending on the overall clinical picture.
‘CTCA has become a primary method for the diagnosis of Coronary Artery disease.’(Journal of the American College of Cardiology, Aug. 2021)
Low Radiation Dose CTCA Technology.
Like all CT scans, CTCA scans involve the use of a small dose of radiation. The dose for CTCA has dropped over the past decade due to advances in technology, faster scan speeds and increased detector row numbers.
At Panorama Radiology Specialists, our state-of-the-art 640-slice CT scanner utilises Artificial Intelligence with Deep Learning Technology and ultra-fast single-heartbeat scanning, to dramatically reduce CTCA radiation doses by around 80% compared to conventional CT scanners, and around 90-95% compared with Invasive Catheter Coronary Angiography.*
The average radiation dose used for CTCA scans at Panorama Radiology Specialists is comparable around to 6 standard Chest X-Rays, or 10 weeks of normal background radiation exposure.
What Happens During My CT Coronary Angiogram?
Our staff will give you specific instructions for your CT Coronary Angiogram at our Gold Coast clinic. You will be asked to complete an information sheet; please be sure to provide details of any allergies, previous cardiac history, including medications, and any previous cardiac procedures you may have undergone.
We recommend avoiding caffeine (including tea, coffee and caffeinated soft drinks) and smoking for 12 hours prior to your test. Drink plenty of water beforehand to remain hydrated for the scan. Your doctor may give you instructions regarding your usual medication if relevant; please be sure to follow them.
Please bring any old films or reports with you if possible.
You may be required to change into a gown. Generally, an IV line is inserted before the scan to allow an injection of contrast dye.
In some cases, you may need to have Beta Blockers or other medication to lower your heart rate, to allow the highest possible image quality inside the Coronary Arteries. This is less commonly required with our fast acquisition 640 slice CT scanner than conventional CT machines. If required, the medication is administered under the supervision of our CTCA-accredited radiologists or visiting cardiologists.
The technologist will check your heart rate and attach ECG leads to your chest, which allows the scanner to time the scan with a single heartbeat when the heart muscle is most relaxed.
The actual CTCA scan takes around 1/4 of a second, although usually, appointments are typically around 10-15 minutes.
Generally CT Coronary Angiography is not recommended in pregnancy.
Please advise our staff if you are pregnant or think you might be.
CT Coronary Angiogram Fees
PRS Bulk Bills all Medicare-eligible specialist CTCA referrals.
Medicare covers CTCA referrals from any specialist doctor. CTCA includes Calcium Scoring with Medicare-eligible CTCA referrals.
Panorama accepts GP referrals for CTCA, for a modest out-of-pocket fee.
Please ask our staff for more information about our fees.
CT Coronary Angiogram Results
Your results and images will be promptly electronically delivered to your referring doctor. Due to the longer processing times required to produce high-quality CTCA studies, non-urgent results may be slightly delayed. Urgent results are generally communicated promptly to the referring clinician.
You will need to return to see your referring doctor to discuss your results.