Innovations in Cardiac CTA

Abstract

Rapid technological advancements have enabled cardiac computed tomography angiography (cardiac CTA) to become the noninvasive modality of choice for the rule-out of coronary artery disease (CAD). Advances have been driven by progress in CT hardware technology, image reconstruction, and post-processing software. Diagnostic performance of cardiac CTA has been improved by the faster gantry rotational times and the corresponding improvement in temporal resolution. Another crucial contribution has been the development of large coverage detectors with more rows added, enabling to go from spiral to prospective axial acquisitions and reduce the dose exposure by as much as 80%. The development of iterative and other advanced reconstruction methods have facilitated this radiation dose reduction further in combination with improvements in low contrast and spatial resolution, making it also possible for functional information, such as myocardial perfusion and flow information to be extracted as well from cardiac CTA. Novel approaches have been developed to address functional motion analysis and motion artifact reduction for improved anatomic analysis. Cardiac dual-energy CT is among the latest developments which might enable further improvements in the diagnostic performance and robustness of this application, and give CT the potential to become the prime imaging modality in the field of cardiovascular medicine.