When It Comes to Cardiac CT, Specialized Credentialing is Essential

The topic of cardiac CT credentialing came up at the recent International Society for Computed Tomography meeting and raises interesting points on the specialized training. Some wonder with the comprehensive residency and fellowship training that’s required to earn the title of “radiologist”, just how necessary this special credentialing for cardiac CT is. Dr. U. Joseph Schoepf of the Medical University of South Carolina points out that it is essential and ideal for cardiac imaging.

Schoepf notes, “The truth is that cardiac CT is the new kid on the block for many practitioners who finished their training more than a decade ago.” He went on to say that anyone who wants to read cardiac CT needs special training, but “there aren’t enough institutions out there that have enough volume in cardiac CT to really appropriately train residents and fellows.”

Dr. Schoepf is 100 percent correct. Cardiac CT requires relatively extensive subspecialty training plus a fair amount of experience for proficiency. Even a Board Certified Radiologist can’t pick it up overnight or at a weekend course.

Subspecialty certification and re-certification after an appropriate time are very good initiatives. A Certification of Added Qualification (CAQ) in cardiac CT is just as meaningful as one in Pediatric Radiology or Interventional Radiology. It provides some assurance about a radiologist’s level of knowledge and practice excellence.

To read more about the importance of experience when it comes to CT, please click here.

Low Dose CT for Cardiac Imaging

Findings of a recent population-based study featured in the Journal of American College of Cardiology (JAAC) suggest cardiac imaging may be putting younger adults at risk due to radiation exposure.

“The study demonstrated that there are sizable rates of radiation exposure for patients 35-54 years, many of whom will likely live long enough for such long-term complications (as malignancy) to potentially develop,” wrote Jersey Chen, MD.

While the results may make cardiologists give further thought to the tests they recommend and alternatives they can use, others point out that the benefits of the test must be weighed against the risks of radiation exposure.

It is very unusual for a patient in this age range to get a cardiac CT scan. But if they do need one, we can now scan them using less than 2 mSv of radiation (compared to 10-25 mSv in 2005).

That means the risk of dying from a cancer induced by the CT scan (1 in 4,000) is about the same as the risk of dying in a car accident if they were to drive 70,000 miles (about 5 years of driving for the average American) which is also about 1 in 4,000.