Dr. Sujith Kalathiveetil Featured in Diagnostic Imaging on the Evolution of CCTA

In a recent interview with Diagnostic Imaging, Sujith Kalathiveetil, MD, FACC, discussed the evolution of coronary computed tomography angiography (CCTA), AI-enabled tools and the potential for future innovations with CCTA.

Reimbursement often plays a key role in the adoption of technology advances, and it was no different with the evolution of coronary computed tomography angiography (CCTA), noted Sujith Kalathiveetil, MD, FACC, in a recent interview with Diagnostic Imaging.

Despite the increasing evidence, including 2021 guidelines from the American College of Cardiology and the American Heart Association, supporting the use of CCTA in first-line evaluation of chest pain, Dr. Kalathiveetil recalls a time where facilities looking at the return on investment with scanner purchases saw higher reimbursement with modalities that were “arguably inferior” to CCTA. However, reimbursement trends have been catching up with the evidence in recent years, according to Dr. Kalathiveetil.

“I find that, if anything, the pendulum has swung in the other direction now, where insurance groups are pushing coronary CTA because they’re wise to the fact that it’s very, very cost-efficient,” noted Dr. Kalathiveetil, the director of cardiac imaging at Advocate Good Samaritan Hospital in Downers Grove, Ill.

Dr. Kalathiveetil suggested there are more advances to come with CCTA, including the potential for AI-powered fractional flow reserve (FFR) CT assessments in stented vessels.

“That’s going to be a game changer, honestly, when we’re able to perform FFR-CT in revascularized vessels. We’re not there yet, but that’s going to really move the ball forward,” posited Dr. Kalathiveetil, a co-director of cardiac imaging at Northwestern Medicine Central DuPage Hospital in Winfield, Ill.

While there are multiple AI-enabled software modalities for plaque analysis on CCTA, Dr. Kalathiveetil envisions the eventual arrival of software that can facilitate longitudinal tracking of plaque volume in response to treatment.

“There’s no modality right now that has the ability to do that, and that, to me, is going to be one of the final big pieces of the puzzle,” maintained Dr. Kalathiveetil.