BJR publishes BSCI/BSCCT and BSTI consensus statement on reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic CT
Consensus statement by the British Society of Cardiovascular Imaging/British Society of Cardiovascular Computated Tomography and the British Society of Thoracic Imaging
BJR,the flagship research journal of the British Institute of Radiology, has published a Guidelines and Recommendations article entitled “Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI” by Michelle Claire Williams and colleagues.
Cardiovascular disease is one of the leading causes of death in the western world, with coronary artery disease accounting for >10% of all deaths in the UK in 2017. Early detection of coronary artery disease can significantly reduce future coronary events and lead to a reduction in morbidity and mortality.
The aim of this joint guideline from the British Society of Cardiovascular Imaging/British Society of Cardiac Computed Tomography (BSCI/BSCCT) and British Society of Thoracic Imaging (BSTI) is to provide guidance for radiologists for reporting incidental coronary and cardiac calcification on routine thoracic CT performed for non-cardiac indications without electrocardiogram gating. The article recommends the reporting of coronary artery calcification (CAC) when visualised on all CT scans, provides guidance on how to classify the severity of CAC on a per patient basis, and aims to increase the awareness of the prognostic implications of CAC.
Access the article here: https://doi.org/10.1259/bjr.20200894
Notes for Editors
BJR article information
Title: Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI
Authors: Michelle Claire Williams, Ausami Abbas, Erica Tirr, Shirjel Alam, Edward Nicol, James Shambrook, Matthias Schmitt, Gareth Morgan Hughes, James Stirrup, Ben Holloway, Deepa Gopalan, Aparna Deshpande, Jonathan Weir-McCall, Bobby Agrawal, Jonathan C L Rodrigues, Adrian J B Brady, Giles Roditi, Graham Robinson and Russell Bull
DOI: https://doi.org/10.1259/bjr.20200894
Abstract:
Incidental coronary and cardiac calcification are frequent findings on non-gated thoracic computed tomography (CT). We recommend that the heart is reviewed on all CT scans where it is visualised. Coronary artery calcification is a marker of coronary artery disease and it is associated with an adverse prognosis on dedicated cardiac imaging and on non-gated thoracic CT performed for non-cardiac indications, both with and without contrast. We recommend that CAC is reported on all non-gated thoracic CT using a simple patient-based score (none, mild, moderate, severe). Furthermore, we recommend that reports include recommendations for subsequent management, namely the assessment of modifiable cardiovascular risk factors and, if the patient has chest pain, assessment as per standard guidelines. In most cases this will not necessitate additional investigations. Incidental aortic valve calcification may also be identified on non-gated thoracic CT and should be reported, along with ancillary findings such as aortic root dilation. Calcification may occur in other parts of the heart including mitral valve/annulus, pericardium and myocardium, but in many cases these are an incidental finding without clinical significance.
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