On its update published in the Journal of the American College of Cardiology, the appropriate indications for cardiac CT are greatly expanded but they are closely related to the results of prior test (i.e., ECG, biomarkers), pretest probability of CAD and ability of patients to exercise.
For the detection of coronary artery disease (CAD), many indications are considered appropriate:
1. Symptomatic patients with nonacute symptoms possibly representing an ischemic event -- when the patient has intermediate probability of CAD, or low probability but unable to exercise or ECG uninterpretable
2. Symptomatic patients with acute symptoms suspicious of acute coronary syndrome -- when there is a low or intermediate probability
3. CAD/Risk assessment in asymptomatic individuals (coronary calcium scoring)
4. New-onset or newly diagnosed clinical heart failure and no prior CAD
5. Preoperative coronary assessment prior to noncoronary cardiac surgery
This is just a small part of the recommendation, please follow the link to get to the full paper.
ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. J Am Coll Cardiol 2010;56:1864-1894.