Triple Rule-Out and Peripheral MRA

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Chris P. Kaiser, Editor

The so-called triple rule-out—a single cardiac CT angiography (CTA) exam to evaluate for coronary artery disease, pulmonary embolism (PE) and aortic dissection—has not had an easy road to mainstream acceptance. And for good reason. It tends to increase radiation exposure, compared to a coronary CTA study, and the majority of studies are negative for PE and dissection.

But newer radiation reduction protocols can reduce exposure by up to 75 percent. With that in mind, researchers at Thomas Jefferson University tested the triple rule-out in several scenarios and found the technique favorable, particularly with careful patient selection.

The senior author of the studies explained to Cardiovascular Business News how the advanced visualization techniques are easy to perform and beneficial to accurate interpretation. Read the complete story here.

Our other top story deals with 3D MR angiography (MRA) to assess peripheral occlusive disease. This topic is especially timely as more cardiologists venture into the peripheral vasculature. The authors outline a way to get optimal contrast enhancement from the pelvis to the feet during one scan. They also discuss the MRA imaging parameters and post-processing techniques, which, says the lead author, is not only scientific, but also “an art.” Read the complete story here.

We are also featuring a story about a meeting between cardiovascular CT providers and payors—both private and public. During the meeting, the payors expressed optimism that the time is near when they will cover coronary CTA in an emergency department setting.

Another story I’d like to point out demonstrates the research into using CT to evaluate cardiac function. Researchers compared functional cardiac CT with MRI and various echo techniques. The research is promising and the functional information is generally available with routine coronary CTA exams. Some imagers claim that patients have already been irradiated to test for coronary disease, so they have a right to provide referring physicians with functional information if it’s available.

The December issue of our sister publication Health Imaging & IT contains a feature titled “Cardiac SPECT Sharpens Its Focus.” I encourage you to read it to discover the ways in which cardiac SPECT is continuing to advance.

I also encourage you to link to our Healthcare TechGuide, which contains a calendar of events, whitepapers and company listings, including those focused on advanced visualization.

On these or any other topics, please send me your comments. Happy Holidays and we’ll see you next year.

Chris P. Kaiser, Editor
ckaiser@cardiovascularbusiness.com