Thread by @DavidJHur1

Happening Now on #SCCT2020 Channel 3! Scan Challenges & Safety Drs. @armin_zadeh @bchowmd Mohamed Marwan Marcus Chen @AndrewEinstein7 @MarcoRengo @HanZhuMD
Having trouble deciding b/w multiple channels of such great #YesCCT content? View now or OnDemand!
@Heart_SCCT @FiRSTSCCT

https://twitter.com/davidjhur1/status/1284161364622225414?s=21

https://twitter.com/davidjhur1/status/1284161364622225414

https://twitter.com/davidjhur1/status/1284164710603067394?s=21

https://twitter.com/davidjhur1/status/1284164710603067394

3/ #YesCCT Scan Challenges & Safety
Dr. Chen - CAC/stents
overcoming partial volume effects
HR control - minimize motion
adjust tube current, tube voltage
#SCCT2020 @Heart_SCCT

4/ #YesCCT Scan Challenges & Safety
Dr. Chen - CAC/stents
review all acquired phases
thinnest slice possible
optimize window/level
model-based iterative recon
#SCCT2020 @Heart_SCCT

https://twitter.com/davidjhur1/status/1284188869638815745?s=21

https://twitter.com/davidjhur1/status/1284188869638815745

5/ #YesCCT Scan Challenges & Safety
Dr. Chen - CAC/stents
coronary subtraction
ultra-high res CT
future: DE/spectral & photon-counting detector CT
#SCCT2020 @Heart_SCCT

https://twitter.com/davidjhur1/status/1284191637891985409?s=21

https://twitter.com/davidjhur1/status/1284191637891985409

6/ #YesCCT Scan Challenges & Safety
Dr. @AndrewEinstein7 - ⬇️radiation dose
modern scanners
personalized protocols
adaptive scan modes
#SCCT2020 @Heart_SCCT

7/ #YesCCT Scan Challenges & Safety
Dr. @AndrewEinstein7 -⬇️radiation dose
tube kVp adjustment
iterative reconstruction - advanced IR can ⬇️mean DLP by 80% (74.6 to 14.9)!!!
#SCCT2020 @Heart_SCCT

8/ #YesCCT Scan Challenges & Safety
Dr. @MarcoRengo - Contrast Nephropathy
true CI-AKI risk historically overestimated, but need precautions
#⃣1⃣ risk PC-AKI is⬇️renal fxn/CKD
SCr/eGFR practical/cheap markers
appropriate hydration, CM reduction, avoid nephrotox agents🔑
#SCCT2020

9/ #YesCCT Scan Challenges & Safety
Dr. @HanZhuMD - Contrast Catastrophes
IodinatedCM>GBCA, but rare (0.6% aggregate, 0.04% severe)
TX: don't forget ACLS,💉epi 0.3 mg IM or 0.1 mg IV); H1-blocker diphenhydra 25-50 mg for hives (PO if mild; IV/IM if mod-sev)
Document!
#SCCT2020

10/ #YesCCT Scan Challenges & Safety
Dr. @HanZhuMD - Cont Rxn PPX: prednisone 50mg @ 13/7/1hr b/f scan OR methylpred 32mg @ 12/2hr b/f scan; acceleratd IV: methyl pred 40mg or hydrocortisone 200mg NOW (& q4h); also 4 all diphenhydramine 50mg 1hr prior
👀4 brkthru cont rxn (2.1%)

11/ #YesCCT Scan Challenges & Safety
Thank You to Speakers Drs. Marwan, Chen, @AndrewEinstein7, @MarcoRengo, @HanZhuMD for such outstanding and useful talks! Thank You to Chairs Drs. @armin_zadeh & @bchowmd for a phenomenal session!
#SCCT2020 #YesCCT @Heart_SCCT @YaleCardiology