Impact of 64-slice multidetector computed tomography on other diagnostic studies for coronary artery disease.

Background: The clinical role of cardiovascular multidetector computed tomography (CT) remains in evolution, and application varies widely. Understanding its impact on the utilization of other cardiovascular diagnostic modalities could help define best practices.
Methods: Utilization of diagnostic testing was examined for the initial 1053 consecutive patients who underwent cardiovascular multidetector CT examinations after scanner installation in 2005. Yearly procedural volumes in the invasive catheterization and noninvasive stress laboratories were assessed before and after the introduction of multidetector CT.
Results: Ninety-one patients (8.6%) of the 1053 required invasive diagnostic catheterization; of these, nearly half subsequently underwent percutaneous or surgical intervention. Diagnostic catheterization and interventional volumes maintained their previous rates of annual increase, while the volume of stress testing decreased once multidetector CT became available.
Conclusions: The major impact of multidetector CT in initial cardiovascular practice is on the need and frequency of stress testing, with far less impact on utilization of cardiac catheterization and coronary interventions.