- © 2007 Canadian Medical Association or its licensors
I read with interest Esteban Escolar and colleagues' article on new tomographic cardiovascular imaging techniques.1 In my opinion, the greatest diagnostic advantage of multiple-slice spiral computed tomography (CT) angiography is in investigations of patients at high risk of coronary artery disease, contrary to the view of the authors. They do not point out the excessive radiation dosage to which the patient is exposed by multiple-slice spiral CT angiography: a scan requires a minimum of 850 mA of current and the radiation dose varies from 18 mSv to 22 mSv.2 Are we sure that conventional noninvasive cardiac tests (such as dobutamine stress echography) are not adequate to identify myocardial ischemia in patients at low risk of coronary artery disease? What are the advantages of using coronary CT angiography for such patients, usually aged 45 years or younger, and exposing them to excessive radiation?