ProtocolPulse

CT Coronary Angiography

CT
NICE CG95 (2010, updated November 2016)v2.0 · March 2026
Routine
Outpatient
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)

CTCA first-line

— ANY of the following

  • Typical anginal symptomsNICE CG95
  • Atypical anginal symptomsNICE CG95
  • Non-anginal chest pain with abnormal resting ECGNICE CG95

Key changes from 2010 to 2016

— Information section — documenting removed investigations

  • Pre-test probability model: REMOVED
  • CT calcium scoring as separate first step: REMOVED
  • ETT: REMOVED as recommended investigation
  • Functional imaging: now SECOND-LINE only

Functional imaging second-line

— ANY of the following

  • Known CAD with new/changing symptoms
  • CTCA technically inconclusive
  • CAD of uncertain functional significance
  • Options: stress echo, CMR stress perfusion, MPS-SPECT

Notes

Warning

References to 'NG203' for chest pain are INCORRECT — no such guideline exists. Correct is CG95 (updated 2016)

Information

ETT no longer recommended

Information

CTCA now first-line, not calcium scoring

Radiation Dose

CTCA effective dose ~2–5 mSv. Prospective ECG gating reduces dose.

Guideline Corrections

NG203 → CG95 (2010, updated November 2016)

NG203 does not exist. CG95 remains current for stable chest pain assessment.

Change Log

v2.02026-03-08New protocol — CT coronary angiography per CG95. NG203 correction flagged.

Not clinical advice. This protocol is a reference tool only. All imaging justifications remain the clinical and legal responsibility of the authorising practitioner under IR(ME)R 2017 (as amended 2024). Protocol content should be verified against current NICE, RCR, and specialty guidelines before use in practice.

AI-assisted content. Clinical criteria were developed with AI assistance and cross-referenced against cited source guidelines. Verify against original sources. Guidelines referenced are current at the stated version date and may have been updated since.