Athens Cardiology Update

Arkadios Rousakis
2014 International Cardiology Symposium in Athens   unpublished
Significant improvements in technical capabilities of multislice computed tomography (MSCT) scanners over the recent years have resulted in better temporal and spatial resolution of computed tomography coronary angiography (CTCA) and a decrease of the acquisition time and reduction of the radiation dose. CTCA has been validated as having an excellent negative predictive value for ruling-out coronary artery disease (CAD) in populations with low-to-intermediate pretest probability and a high
more » ... ity and a high accuracy for detecting CAD in patients with atypical chest pain. It can also aid in decision-making for the clinical management of patients found to have significant coronary artery stenoses and in the follow-up these patients. The recent improvements of this technology are herein briefly overviewed. I N t r O D U c t I O N Since the advent of multi-slice computed tomography (MSCT), about 15 years ago, there has been a continuous and significant improvement of the technical capabilities of this revolutionary technique. Among many other clinical applications, this progress has resulted into an increasing role of non-invasive computed tomography (CT) coronary angiography (CTCA) in the detection of coronary artery disease (CAD). t E c H N I c A L A s P E c t s The capability of high temporal resolution is crucial for minimizing the time needed for imaging data collection and, subsequently, for "freezing" the movement of coronary arteries during heart pulsation. The first generation of MSCT scanners, capable to obtain 4 slices per gantry rotation, was characterized by a temporal resolution of 400 ms, which improved to 250 ms in the 16-slices scanners, gradually to 165 ms (64-slices scanners) and 83 ms in dual-source CT scanners. Spatial Resolution influences the quality of images and, specifically in the case of CTCA, the possibility to image the smaller distal coronary segments and evaluate the structure of the atherosclerotic plaque. From 4x1mm in the 4-slices scanners, spatial resolution was improved to 16x0.75 mm in the 16-slices machines and then to 64x0.6-0.4 mm in the scanners capable to obtain 64 or more slices. tEcHNIQUEs AbbreviAtions CAD = coronary artery disease CCS = coronary calcium score CT = computed tomography CTCA = compute tomography coronary angiography ECG = electrocardiogram ERD = effective radiation doses MSCT = multi-slice computed tomography SPECT = single-photon emission computed tomography Conflict of interest: none declared