Dave Fornell, ITN Editor
Dave Fornell, ITN Editor

Dave Fornell is the editor of Diagnostic & Interventional Cardiology magazine and assistant editor for Imaging Technology News magazine.

Blog | Dave Fornell, ITN Editor | September 03, 2014

Future Cardiovascular CT Advances to Watch

As technology continues to advance for all diagnostic imaging modalities, it sometimes reminds me of a race between vendors to build a better mouse trap. The main issue between cardiac echo, computed tomography (CT), magnetic resonance imaging (MRI), nuclear (SPECT and PET) and invasive angiography is that each has its strengths and weaknesses. When one test falls short, another is used to add diagnostic information, but it also adds time and cost. Unfortunately, in this era of cutting costs and bundled payments, the holy grail of medical imaging would be a one-stop shop cardiac imaging test that combines the majority of the key assets of each of these modalities.

I attended the Society of Cardiovascular Computed Tomography (SCCT) annual meeting in July, where both cardiologists and radiologists came together to make a case for why CT will become the primary cardiac imaging test in coming years. It showed CT radiation is declining and new technology can bring cardiac CT doses below 1 mSv, which is key to CT’s wider acceptance. Data from several trials demonstrate the viability of CT to accurately show myocardial perfusion and fractional flow reserve (FFR) data for the entire coronary tree from a single scan. Work is also continuing to improve plaque characterization software to bring it on par with invasive catheter-based virtual histology intravascular ultrasound (VH-IVUS) or spectrographic plaque analysis. Additionally, spectral CT imaging may enable a new way to image chemical makeup of tissue and allow new types of contrast media. 

Speakers at SCCT discussed the use of gold nanoparticles with a polyethylene glycol (PEG) coating, or tantalum, as replacement agents for iodine blood imaging; bromide and fluorine with a phospholipid coating to image liver tumors; and iodine-loaded or bismuth nanoparticles with a biomarker to target fibrin to clearly image blood clots. Nanoparticles may also boost the ability of iodine as a contrast agent. By coating iodine inside liposome particles, the outer shell will protect the iodine from breaking down immediately, both extending its imaging half-life and possibly aiding renal clearance over a longer period of time to reduce contrast-induced nephropathy (CIN). 

New types of contrast, especially if combined with spectral CT, may enable inflammation and macrophage imaging, both components of vulnerable plaque. If validated, this new way to image vulnerable plaques prior to rupture might offer a novel way to determine heart attack risk and possibly identify lesions to stent before a heart attack occurs.  

To read more on these and other cardiac CT advances, see the article from the September-October 2014 issue of DAIC. 

Watch a video interview regarding these advances in cardiac CT.

Related Content

Largest case series (n=30) to date yields high frequency (77%) of negative chest CT findings among pediatric patients (10 months-18 years) with COVID-19, while also suggesting common findings in subset of children with positive CT findings

A and B, Unenhanced chest CT scans show minimal GGOs (right lower and left upper lobes) (arrows) and no consolidation. Only two lobes were affected, and CT findings were assigned CT severity score of 2. Image courtesy of American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | May 29, 2020
May 29, 2020 — An investigation published open-access in the ...
Examples of chest CT images of COVID-19 (+) patients and visualization of features correlated to COVID-19 positivity. For each pair of images, the left image is a CT image showing the segmented lung used as input for the CNN (convolutional neural network algorithm) model trained on CT images only, and the right image shows the heatmap of pixels that the CNN model classified as having SARS-CoV-2 infection (red indicates higher probability). (a) A 51-year-old female with fever and history of exposure to SARS-

Figure 1: Examples of chest CT images of COVID-19 (+) patients and visualization of features correlated to COVID-19 positivity. For each pair of images, the left image is a CT image showing the segmented lung used as input for the CNN (convolutional neural network algorithm) model trained on CT images only, and the right image shows the heatmap of pixels that the CNN model classified as having SARS-CoV-2 infection (red indicates higher probability). (a) A 51-year-old female with fever and history of exposure to SARS-CoV-2. The CNN model identified abnormal features in the right lower lobe (white color), whereas the two radiologists labeled this CT as negative. (b) A 52-year-old female who had a history of exposure to SARS-CoV-2 and presented with fever and productive cough. Bilateral peripheral ground-glass opacities (arrows) were labeled by the radiologists, and the CNN model predicted positivity based on features in matching areas. (c) A 72-year-old female with exposure history to the animal market in Wuhan presented with fever and productive cough. The segmented CT image shows ground-glass opacity in the anterior aspect of the right lung (arrow), whereas the CNN model labeled this CT as negative. (d) A 59-year-old female with cough and exposure history. The segmented CT image shows no evidence of pneumonia, and the CNN model also labeled this CT as negative.  

News | Coronavirus (COVID-19) | May 19, 2020
May 19, 2020 — Mount Sinai researchers are the first in the country to use...
Advanced imaging data exchange is now live in Colorado due to the partnership of Health Images and the Colorado Regional Health Information Organization

Getty Images

News | Radiology Business | May 18, 2020
May 18, 2020 — 
Radiologists from Shanghai discuss modifying exam process and disinfecting exam room, while outlining personal protection measures during the coronavirus disease outbreak

(HIS = hospital information system, RIS = radiology information system) Image courtesy of American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | May 18, 2020
May 18, 2020 — In an open-access article published ahead-of-print
Now a research team — led by Tohoku University Professor, Wataru Yashiro — has developed a new method using intense synchrotron radiation that produces higher quality images within milliseconds.

How the bent crystal changes the direction of the X-rays. Image courtesy of Tohoku University

News | Computed Tomography (CT) | May 15, 2020
May 15, 2020 — Many will undergo a computed tomogr...
In today’s challenging healthcare environment, radiology departments are often faced with the difficult decision of how to safely image patients who are suspected of being positive with infectious disease. To help hospitals and institutions effectively utilize computed tomography (CT) with these conditions, Canon Medical Systems USA, Inc. introduces a deployable CT with a rapid decontamination solution.
News | Computed Tomography (CT) | May 11, 2020
May 11, 2020 — In today’s challenging healthcare environment, radiology departments are often faced with the difficul
Axial (A) and coronal (B) CT of the abdomen and pelvis with IV contrast in a 57-year-old man with a high clinical suspicion for bowel ischemia. There was generalized small bowel distension and segmental thickening (arrows), with adjacent mesenteric congestion (thin arrow in B), and a small volume of ascites (* in B). Findings are nonspecific but suggestive of early ischemia or infection.

Axial (A) and coronal (B) CT of the abdomen and pelvis with IV contrast in a 57-year-old man with a high clinical suspicion for bowel ischemia. There was generalized small bowel distension and segmental thickening (arrows), with adjacent mesenteric congestion (thin arrow in B), and a small volume of ascites (* in B). Findings are nonspecific but suggestive of early ischemia or infection. Image courtesy of RSNA

News | Coronavirus (COVID-19) | May 11, 2020
May 11, 2020 — Patients with COVID-19 can have b