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Congress: ECR25
Poster Number: C-17773
Type: Poster: EPOS Radiologist (scientific)
Authorblock: C. Bini, A. Lupi, G. Galia, R. Bianco, E. Quaia, G. Gerosa, A. Pepe; Padua/IT
Disclosures:
Costanza Bini: Nothing to disclose
Amalia Lupi: Nothing to disclose
Giuliana Galia: Nothing to disclose
Roberto Bianco: Nothing to disclose
Emilio Quaia: Nothing to disclose
Gino Gerosa: Nothing to disclose
Alessia Pepe: Nothing to disclose
Keywords: Cardiac, Radioprotection / Radiation dose, CT-Angiography, Radiation safety, Socio-economic issues, Dosimetric comparison, Economics, Occupational / Environmental hazards, Sustainability
Results

Eighty-five patients were finally included, 52 males, mean age 61±13 years. All CCT scans were diagnostic, without recorded complications. Twenty-one patients (25%) showed no stenosis (CAD-RADS 0) and CA 0, eighteen (21%) had minimal stenosis (CAD-RADS 1) and CA 36 ± 59, and nineteen (22%) had mild stenosis (CAD-RADS 2) and CA 240 ± 309.

Nineteen (22%) patients showed moderate stenosis (CAD-RADS 3) and CA 545 ± 386, of these

  • 2 underwent stress Cardiac Magnetic Resonance (CMR), one of them with positive result and subsequent positive ICA;
  • 1 underwent Single Photon Emission Computed Tomography (SPECT) and then ICA, both with positive result;
  • 7 underwent ICA directly (with positive results in 6);
  • 9 did not yet perform further examinations.

Seven patients (8%) had severe stenosis (CAD-RADS 4) and CA 1494 ± 1307, among these 1 underwent stress CMR (negative) and 6 underwent ICA (4 positive, 2 negative).

One patient (1%) with total occlusion (CAD-RADS 5) and CA 0 ± 0 underwent ICA which confirmed the CCT findings.

By this non-invasive preoperative strategy, 69 (81%) of patients avoided ICA. [Table 1]

Table 1: Summary of CCT results and further management. © Institute of Radiology, Department of Medicine DIMED, Padua University Hospital 2024.

The relative and absolute costs of the non-invasive strategy was significantly lower compared to the scenario where all patients were sent directly to ICA (11.7 ± 16.6 vs 41.8 ± 0; 807.6 ± 1074.7 € vs 2645.59 ± 0 €, respectively; p value <0.00001). [Tables 2 and 3]

Table 2: relative costs of CCT-strategy population vs ICA-strategy. Considered relative costs are CCT 3.4, CMR 5.1, ICA 41.8, according to EVINCI study [4]. © Institute of Radiology, Department of Medicine DIMED, Padua University Hospital 2024.
Table 3: average costs for diagnostic procedures carried out in CCT strategy vs ICA-strategy, according to Veneto Region tariff. © Institute of Radiology, Department of Medicine DIMED, Padua University Hospital 2024.
Also, the effective dose of radiations was significantly different between the non-invasive strategy and the traditional invasive strategy (5.8 ± 5.7 mSv vs 12.5 ± 0 mSv, respectively; p value < 0.00001). [Table 4]
Table 4: average effective dose in CCT-strategy vs ICA-strategy [5]. © Institute of Radiology, Department of Medicine DIMED, Padua University Hospital 2024.
Finally, the non-invasive strategy showed also a significantly lower CO2 emission in comparison to the invasive ICA strategy (56.4 ± 96.0 vs 243 kg ± 0, respectively; p value <0.00001). [Table 5]
Table 5: average CO2 emissions for diagnostic procedures carried out in CCT-strategy vs ICA-strategy [6,7]. © Institute of Radiology, Department of Medicine DIMED, Padua University Hospital 2024.
GALLERY