Cardiovascular CT, MRI, and PET/CT

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 0.50
Procedures: 0.50
Interventional Procedures: 0.50

Computed Tomography: 1.50
Procedures: 1.50
Neck and Chest: 1.50

Nuclear Medicine Technology: 0.50
Procedures: 0.50
Cardiac Procedures: 0.50

Registered Radiologist Assistant: 1.50
Procedures: 1.50
Thoracic Section: 1.50

Outline

1. Introduction
2. Coronary Artery Disease
   1. Severity and Extent of Coronary Artery Disease
   2. Ischemia versus Coronary Stenosis
   3. Sex Differences in Plaque Prevalence and Characteristics
   4. Fractional Flow Reserve CT versus Conventional Management for Stable Angina
3. Structural Heart Disease
   1. Hypoattenuated Leaflet Thickening
   2. Aortic Valve and CAC Scores
4. Cardiomyopathies
   1. Predicting Outcomes Using Cardiac MRI
   2. Left Ventricular Noncompaction
5. Valves
   1. Mitral Valve Prolapse
   2. Severe Mitral regurgitation
6. Systemic Disease
   1. COVID-19 Disease
   2. HIV Infection
7. Cardiac PET/CT
   1. Cardiac Sarcoidosis
   2. Prognosis
   3. Bioprosthetic Valve Degenaration
8. Articicial Intelligence and Machine Learning
9. Statements and Guidelines
   1. Guidelines for the Evaluation and Diagnosis of Chest Pain
   2. Updated End Points for Aortic Valve Disease
   3. Cardiac Amyloidosis
   4. Multimodality Imaging and Myocardial Viability
10. Frontiers in Imaging Science
    1. Quantification of MI
    2. Photon-Counting CT
11. Conclusion

Objectives

Upon completion of this course, students will:

1. be familiar with the primary objective of the VERDICT trial
2. be familiar with the factors in defining the primary endpoint in the VERDICT trial
3. be familiar with the major adverse cardiovascular events according in the CADS-RADS
4. be familiar with the ISCHEMIA trial
5. be familiar with the findings of the ISCHEMIA trial
6. be familiar with the primary objective of the William et al study
7. recognize the plaque characteristics in men versus women
8. be familiar with findings of the FORECAST trial
9. be familiar with the characteristic finding for subclinical leaflet thrombosis post TAVR using 4 dimensional cardiac CT
10. be familiar with the incidence of hypoattenuated leaflet thickening at 30 days post-TAVR
11. be familiar with the mortality rates for patients with hypoattenuated leaflet thickening
12. be familiar with the end points in the study comparing aspirin versus warfarin plus aspirin after TAVR
13. be familiar with the primary objective of the study conducted by Eberhard et al
14. be familiar with the CAC threshold as an independent predictor of 1-month and 1-year after TAVR
15. recognize how incorporating the CAC score into the EuroSCORE II impact risk stratification for patients undergoing TAVR
16. be familiar with the primary focus of the PARADIGM registry
17. be familiar of the need for further investigation into the association between aortic valve calcification and cardiac events
18. be familiar with the guideline recommending implantable defibrillator placement in nonischemic dilated cardiomyopathies
19. be familiar with the association between LGE and arrhythmic events across LVEF strata
20. be familiar with the prospective, longitudinal outcomes registry involving patients with dilated cardiomyopathy
21. be familiar with the “ringlike’ pattern of LGE defined in the retrospective observational study
22. identify the composite outcome observed after the median follow-up regarding patients with different patterns of LGE
23. be familiar with what characterizes left ventricular noncompaction (LVNC)
24. be familiar with the percentage of the population affected by mitral valve prolapse
25. be familiar with LGE correlation with the severity of mitral regurgitation
26. be familiar with the two echocardiographic findings that may indicate possible severe mitral regurgitation
27. be familiar with the cardiac MRI use in measuring regurgitant volume
28. be familiar with the findings observed with mild to moderate COVID-19 disease as observed during cardiac MRI
29. be familiar with the finding when evaluating patients recovering from moderate to severe COVID-19 disease pneumonia using cardiac MRI
30. be familiar with the findings of ¹⁸F-NaF PET/CT in patients who underwent transcatheter aortic valve replacement
31. be familiar with the decreased radiation burden related to doing CAC together with CTA
32. recognize the correlation between semiautomated nonenhanced CT CAC and the deep learning algorithm from coronary CTA
33. identify the functionally relevant features associated with low fractional flow reserve (FFR) per machine learning analysis
34. be familiar with the calculation for myocardial salvage index in the ASSAIL-MI trial
35. identify the advantage of photon-counting CT over conventional CT as indicated in Si-Mohame et al