Technical innovations and concepts in coronary CT

Abstract

By virtue of increased clinical demand, coronary CT angiography (cCTA) has experienced a rapid evolution to overcome the diagnostic challenges in cCTA. This has led to advancements in CT scanner technology, image acquisition techniques, data reconstruction as well as image post-processing. Furthermore, the potential gain of additional information out of cCTA data such as cardiac function parameters led to the development of sophisticated solutions to fulfill these needs. However, although image quality has increased significantly over the last couple of years, the positive predictive value for the prediction of hemodynamic significant stenosis in cCTA remains rather low. To overcome this limitation, innovative approaches like cardiac perfusion, transluminal attenuation gradient, and CT fractional flow reserve have been developed. This chapter will provide an overview on the most crucial innovations in cCTA, explain their technical background, demonstrate their current status, and point out their major limitations.