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Background Heart rate control improves coronary CT angiography (CTCA) image quality and allows dose-saving strategies, with guidelines recommending beta-blockers (BB; metoprolol) to achieve ~60-65 bpm when appropriate. However, advances in scanner technology mean medication requirements may vary across platforms and over time.Aim To quantify annual and scanner-platform differences in BB administration across three hospitals in HHFT, and to assess whether BB-use decreased as scanner technology upgraded from earlier generation multibeat scanning GE HD750 to advanced wide-detector single beat acquisition (Canon PRISM).Methods Retrospective service evaluation using audit data provided (2019-2025), summarised by year, site and scanner. BB proportions (BB/total CTCA) were reported with Wilson 95% confidence intervals (CIs). Unadjusted logistic regression tested temporal trend (odds ratio [OR] per year). Scanner associations were explored with grouped logistic regression, recognising that scanner upgrades and protocol evolution are temporally linked.Results 1535 CTCA studies were included. Overall BB use fell from 85.2% (95% CI 73.4-92.3) in 2019 to 46.7% (95% CI 41.9-51.5) in 2025 (OR per year 0.80, 95% CI 0.75-0.85; p<0.001). By scanner model, BB rates were: GE HD750 - 100.0%, FLASH - 66.1%, PRIME - 63.2% and PRISM - 47.7%. Compared with PRIME, PRISM had lower odds of BB use (OR 0.53, 95% CI 0.42-0.68; p<0.001) (tables 1 and 2).Conclusion BB administration decreased substantially from 2019 to 2025 and was lowest in PRISM-era activity. Newer single-beat technology provide temporal resolution that allows for scans at higher rates compared to older generation machines. Reduced metoprolol requirements materially improves workflow, removing time spent administering drugs. Across all years combined, which scanner model label had the lowest BB administration rate?A. Siemens FLASHB. Canon PRIMEC. Canon PRISMD. Siemens FLASH and Canon PRIME were identical and lowestE. GE HD750Abstract 21 Table 2Aggregated BB by scanner model and siteGroupParameterBB / TotalBB rate (%)Wilson 95% CI (%)ScannerFLASH292 / 44266.161.5–70.3PRIME333 / 52763.259.0–67.2PRISM268 / 56247.743.6–51.8GE HD7504 / 4100.051.0–100.0SiteAWMH291 / 44865.060.4–69.2BNHH398 / 68158.454.7–62.1RHCH208 / 40651.246.4–56.1Abstract 21 Table 1Annual beta-blocker (BB) administration rateYear BB / Total BB rate (%) Wilson 95% CI (%) 2019 46/54 85.2 73.4–92.3 2020 86/128 67.2 58.7–74.7 2021 140/197 71.1 64.4–76.9 2022 164/269 61.0 55.0–66.6 2023 139/228 61.0 54.5–67.1 2024 125/237 52.7 46.4–59.0 2025 197/422 46.7 42.0–51.5 (Correct answer: C)