CT coronary angiography at an ultra-low radiation dose (<0.1 mSv): feasible and viable in times of constraint on healthcare costs

Computed tomography coronary angiography (CTCA) has reached very high standards both in terms of diagnostic performance and radiation dose reduction. This commentary follows a report on CTCA using less than 0.1 mSv in selected patients. This is an extraordinary accomplishment, both for technology and for medicine. The difficult task is now to implement this tool in clinical practice so it can play the best possible role. CTCA can improve diagnostic pathways, can save money for healthcare systems and could even improve pharmacological therapy. All of this may happen, but it will require the combined effort of all the experienced operators in this field, including the referring clinicians. In times of financial constraint, CTCA may also help to restrict ineffective medical expenses. Key Points • CT coronary angiography provides high diagnostic standards in non-invasive cardiovascular medicine. • It should therefore replace other less effective diagnostic tools. • Inappropriate catheter angiography is costly to healthcare systems. • CTCA could help reduce costs of cardiac investigations by around 33 %. • Low radiation doses in CTCA lead to risk-free individualised pharmacological treatment.

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