Cardiac CT Board Review Course Agenda
Day 1
CT Physics I
- X-ray generation
- Radiation: What is it? What does it mean
- Radiation: Measurement (mSv, mGy, mRad, etc.)
- Radiation: Comparison by modality
- Radiation: Risks - clinical applications
- Radiation: Safety - ALARA, government regulations
CT Physics II
- Mechanical aspects of CT
- Technologies - EBT, 16, 64, 256, DS, etc.
- Performance requirements for cardiac CT
- Resolution - temporal, spatial, contrast
- Pitch
- Collimation
- Noise ratios
- Output settings
Acquisition
- Gating - prospective, retrospective
- Patient specific protocols - obesity, slow heart rate, CABG, etc.
- Bolus timing
- Injection protocols
- Contrast media - flow rates, peak opacification, myocardial enhancement, dose, iodine flux
- Factors affecting image quality - body habitus, heart rate and variability, breath hold, timing
Reconstruction and Post-processing
- Reconstruction occurs on the scanner
- Filters and kernels
- Phase
- Slice thickness
- Slice interval (overlap)
- Field of view
- Post-processing occurs on the workstation
- Window and level
- MPR
- MIP
- Orthogonal planes
- Slab thickness
- Centerline
- Volume rendering
Artifacts
- Beam hardening
- Stair step
- Motion
- Heart rate variability
- Phase
- Ectopy
- Respiratory
Patient selection and preparation
- Patient selection
- ACC/AHA appropriateness criteria
- Contraindications
- Risks and benefits based on patient history
- Negative patient characteristics - obesity, heavy calcification, rhythm
- Patient preparation
- Pre-scan education
- Pre-medication - beta/calcium channel blockade, nitroglycerin (contra/indications, risks, dosage, administration)
- Sedation (contra/indications, risks, dosage, administration, post-care)
- Breath-hold techniques
- Allergies - screening and pre-treatment
- Renal insufficiency - screening and pre-treatment
- Permanent pacemakers
- Post-scan "recovery" following administration of cardiac drugs and contrast
Day 2
Coronary anatomy and variants
- Normal
- Anomalies - type and course
- Non-CAD pathology - intramyocardial course (bridging, ostial slit), fistula, AVM, aneurysm
Coronary artery calcium
- Quantification methods - formulae for mass, volume, Agatston score
- Epidemiology
- Diagnostic utility
- Prognostic utility
Coronary artery disease
- Plaque characterization
- Quantification of stenosis
- Occluded vessels
- SVG analysis
- Pre-operative analysis
- Stent analysis (limitations, post-processing techniques)
Non-coronary cardiac pathology
- Structural disease - masses, shunts, aneurysms
- Left atrial anatomy - appendage, PFO, size
- Left ventricle - size, segmental wall motion, EF, MI
- Right ventricle - size, wall motion, ARVD
- Septal defects - ASD, VSD
- Mitral valve - calcification, stenosis, vegetations, valve area
- Aortic valve - bi/tricuspid, calcification, stenosis, insufficiency
- Pulmonic and tricuspid valves (stenosis)
- Pericardium - masses, calcification, effusion
Non-cardiac pathology
- Aortic pathology - variant anatomy, dissection, aneurysm, TGV, PAU, coarctation
- PA pathology - PE, congenital defects
- PV anatomy - anomalous return, stenosis, ablation
- Other - SVC syndrome, persistent left SVC
- Common lung disease
- Mediastinal findings
- Tumors
- Pulmonary nodules
- Pleural effusion
- Other
Location: http://cardiacimaging.ufl.edu/training/ct_board_review-agenda.shtml