The CT Coronary Angiography Service Specification document has been prepared in order to support those who commission cardiac imaging services, specifically CT coronary angiography (CTCA).
The key principle that should override all other considerations is that a cardiac CT service should be of demonstrably high quality irrespective of where or by whom it is delivered. A poorly performed or reported cardiac CT scan may lead to harm just as readily, if less directly, than a poorly performed invasive examination.
In consideration of the ‘appropriateness’ of CTCA as an investigation the key three questions to answer are:
- Is CTCA likely to provide an accurate diagnosis?
- Is CTCA likely to accurately identify patients who may benefit from specific therapies (such as revascularisation)?
- Will incrementally beneficial information regarding the patient’s prognosis result from the CTCA?
At the current time standards for accrediting individuals to perform CTCA exist (through the British Society of Cardiovascular Imaging or BSCI) but not departments. This is likely to change over the next few years in line with other national cardiac imaging societies (such as the British Society of Echocardiography or BSE). One of the key points from the 2010 Cardiac Imaging Report from the National Imaging Board was that where such accreditation standards existed that these should be used as a basis for commissioning services.
I would like to thank Gareth and the BSCI Committee for putting together this document.