Proposed resources required for a comprehensive program for CCT CHD imaging.

Abstract

Background: Cardiac Computed Tomography (CCT) is increasingly used for evaluation of congenital heart disease (CHD) in patients of all ages. Pediatric and adult congenital heart disease (ACHD) surgical programs require high quality CCT imaging as part of the multimodality imaging support expected of comprehensive care centers. Despite these expectations, there are no benchmarks or defined programmatic elements specific to the performance of CCT in patients with CHD. To address this deficit, this manuscript is written by a group of current CHD CCT practitioners and provides a collective opinion regarding the clinical components required, and essential resources needed, to deliver a comprehensive CCT CHD imaging program. Resource allocation was divided into CCT technology, imaging technologist, physician and programmatic support. The group is inclusive of pediatric and adult cardiologists and radiologists and includes practitioners from high and lower resourced programs and countries. Imaging settings are inclusive of academic and private practice, heart centers and combined radiology/cardiology service lines. Challenges and areas for future advocacy to support this growing specialty are proposed to improve performance standards that will consider the expected widespread variation in technical and staffing resources, skillsets, and practice settings for CT in CHD.

Summary: High quality cardiovascular computed tomography is an essential component of pediatric and adult congenital programs and surgical centers. Program growth outpaces resource allocation in most institutions. This opinion paper outlines essential components for technical, technologist and physician resources and programmatic support to develop and maintain a successful CCT in CHD program. Although a small component of most cardiac imaging programs, it is an essential component particularly in complex cases. Institutional and imaging societal commitment is essential to support this emerging field at highest quality.