Combo high-tech CT scans just as good as older imaging to detect coronary artery disease

Heart imaging specialists at Johns Hopkins have shown that a combination of CT scans that measure how much blood is flowing through the heart and the amount of plaque in surrounding arteries are just as good as tests that are less safe, more complex and more time-consuming to detect coronary artery disease and its severity.

"Our findings should reassure cardiologists and patients that the newer, state-of-the-art CT scans are just as good as established older technologies in diagnosing the presence and severity of coronary artery disease," says cardiologist and lead study investigator Richard George, M.D. George will present his latest study findings Nov. 16 at the American Heart Association's (AHA) annual Scientific Sessions in Chicago.

"In addition, the newer CT scans have the added advantages of being easier on the patient, taking less time to perform, using less radiation, and providing physicians with all the information they need in one test," says George, an assistant professor and director of the CT Perfusion Laboratory at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute.

The Hopkins team's findings were a result of a direct comparison study in 50 men and women with suspected arterial blockages who were given both the new combination CT scans along with traditional SPECT nuclear imaging tests and other diagnostic procedures.

The combination CT scans consisted of a regular, high-tech CT angiogram, or CTA, to map any plaque buildup in the heart's arteries, and a so-called CT perfusion imaging test, or CTP, to gauge any slowdown in arterial blood flow.

The test is completed within a half-hour, giving physicians a clear picture of how much plaque has built up inside any particular small artery and whether such narrowing and subsequent hardening have compromised the heart's blood supply. SPECT testing requires at least two hours to allow a chemical tracer of blood flow to be absorbed and then imaged.

Each year, nearly 800,000 American men and women with coronary artery disease suffer a heart attack, resulting in more than 150,000 deaths.

"This combo test really simplifies the diagnosis of coronary artery disease, providing the first comprehensive evaluation of atherosclerosis in the blood vessels and whether any such detected disease puts a patient at greater overall risk of heart attack in the near or long term," says senior study investigator and cardiologist João Lima, M.D.

"If older people are feeling symptoms of heart disease, but not showing reduced blood flow in the heart, then they and their physicians can breathe a sigh of relief because we know that aggressive or invasive therapies are not required," adds Lima, a professor of medicine and radiology at Johns Hopkins.

The new study involved men and women from the Baltimore region who were examined at The Johns Hopkins Hospital because of chest pain, a symptom typically associated with an arterial blockage.