Coronary Disease
Conditions
Keywords
computer tomography, Cardiac, Radiation Reduction, Iterative Reconstruction
Brief summary
Title: Evaluating New Radiation Techniques for Cardiovascular Imaging Background: Cardiac CT angiography is associated with radiation exposure. Different methods of creating CT pictures have been developed to reduce the radiation dose to the subject. The purpose of this research study is to learn whether these low dose research imagings are accurate or predict subject outcomes. Cardiac CT is also used for diagnostic imaging of coronary artery disease and identification of abnormal cardiac structures. An additional purpose of this study is to monitor the progression of cardiac disease. Cardiac imaging software and AI are constantly evolving and requires validation for accuracy. Using existing scan data, updated image software reconstruction can be applied and compared to previous existing standard of care images. Objectives: \- To study new ways of taking pictures of the heart or blood vessels using computed tomography. Eligibility: \- Adults at least 18 years of age who will be having imaging studies to help detect heart or blood vessel problems. Design: * Participants will be screened with a physical exam and medical history. Blood samples will be taken to check kidney function. * Participants will have a CT scan of the heart and blood vessels. A contrast agent may be used to improve the quality of the images. The scanning session may last up to 2 hours. * Timing of and the need for follow up contact will depend on results from the initial scan and may be repeated to assess for late events. Telephone, office contact, or other follow-up of subjects may be done after CCTA to evaluate if the subject had subsequent cardiovascular testing. Further follow up will be based on reported test results.
Detailed description
Cardiac CT angiography is associated with radiation exposure. Different methods of creating CT pictures have been developed to reduce the radiation dose to the subject. The purpose of this research study is to learn whether these low dose research imagings are accurate or predict subject outcomes. Cardiac CT is also used for diagnostic imaging of coronary artery disease and identification of abnormal cardiac structures. An additional purpose of this study is to monitor the progression of cardiac disease. Cardiac imaging software and Artificial Intelligence (AI) are constantly evolving and requires validation for accuracy. Using existing scan data, updated image software reconstruction can be applied and compared to previous existing standard of care images.
Interventions
DEVICECannon Aquilion ONE CT system
To test the diagnostic accuracy of low-radiation dose CT coronary angiography for detecting significant coronary artery stenosis and to determine the prognostic value of low-radiation dose CT coronary angiography for discriminating patient risk of death or major adverse cardiac events.
Sponsors
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* INCLUSION CRITERIA: 1. Clinical indication for a coronary CT angiography exam 2. Age equal to or greater than 18 years 3. Able to understand and willing to sign the Informed Consent Form 4. Able and willing to provide follow-up information
Exclusion criteria
1. Pregnancy 2. If receiving intravenous contrast, severe renal excretory dysfunction, estimated glomerular filtration rate \< 30 mL/min/1.73m2 body surface area according to the Modification of Diet in Renal Disease criteria or as reported by the clinical lab. Glomerular filtration rate will be estimated using the 2021 CK-EPI equation that eliminate the use of race coefficient as reported in CRIS. Screen Failures: Subjects who are screen failures can be re-enrolled once they meet eligibility criteria. Rescreened participants will be assigned the same participant number as for the initial screening.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Compare time-to-first cardiovascular events (death, revascularization more than 90 days after CTA, hospitalization, non-fatal myocardial infarction, stroke) in subjects with >=50% coronary stenosis vs. <50% stenosis. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Compare and/or validate radiation saving techniques such as iterative reconstruction or artificial intelligence based methods against standard imaging techniques for calcium scoring. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
| Evaluate natural history of coronary plaques in subjects with serial imaging if requested by ordering physician, or in subjects with >50% stenosis or high risk plaques on medical therapy. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
| Estimate diagnostic accuracy of cardiovascular evaluations using current CT technology vs. invasive angiography reports/images and vs. stress perfusion MRI reports/images. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
| Evaluate image quality from new CT technology. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
| Survival analysis of subjects identified by CT with significant coronary artery disease (=50% stenosis) vs. subjects without significant coronary artery disease (<50% stenosis). | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
| Estimate radiation dose from clinically performed cardiovascular CT at the NIH compared to outside clinically indicated CTs. | ongoing | The purpose of this research study is to learn whether these new imaging methods are accurate or predict subject outcomes. |
Countries
United States
Contacts
CONTACTMargaret C Lowery, R.N.
CONTACTMarcus Y Chen, M.D.
PRINCIPAL_INVESTIGATORMarcus Y Chen, M.D.
National Heart, Lung, and Blood Institute (NHLBI)
Outcome results
None listed