This article is more than 5 years old. Information may no longer be current.
CT systems, capabilities evolving rapidly
Click Here to Manage Email Alerts
Recent developments in computed tomography will lead to decreased procedure time and higher quality images, according to J. Jeffrey Carr, MD, professor of radiology-breast imaging and cardiovascular imaging, and vice chair for clinical research at Wake Forest University.
“Spatial resolution, temporal resolution and signal-to-noise and contrast-to-noise ratios should be considered,” Carr said. “The key to imaging the heart is to remember the coronary arteries are small,” he said.
Flat panel detectors, laser X-ray source and advanced reconstruction algorithms are some aspects paving the way to these innovations.
Carr cited results from a study of 200 cardiologists that showed CT use is expected to expand during the next three years. “We have an aging population, we have referring physicians who have high expectations for imaging, and we have more people who are going to need imaging. We need to figure out a way to do it faster and cheaper,” he said.
During the next five years, CTs will evolve into panel detectors, according to Carr. “There are many engineering and technical reasons that we cannot do it right now. For example, there would be a fivefold increase in dose, and that is not tenable as far as patient care goes.”
Currently, one vendor has a 256 channel scanner and another has a 320 channel scanner, according to Carr. “Each has greater length in detector to cover more of the heart for each rotation. Instead of having to do two or three rotations, you rotate one time around the heart, covering the whole thing — more similar to having a panel detector.”
In terms of temporal resolution, gantry rotation speed continues to get faster, according to Carr.
Dual or two tubes is another innovation in CT. “There are two tubes and two detectors, so within a half rotation you are able to obtain more information,” Carr said.
“Reconstruction algorithms are something coming down the pipeline,” Carr said. Iterative reconstruction allows for an exact representation of the data. “You can use algorithms by dividing the gantry speed by two, and if you use the half-scan or segmented reconstruction algorithm, that gives you the total resolution of the images,” he said.
All vendors are talking about dual energy CT as well, according to Carr. Dual energy provides a way of getting an additional contrast agent without giving an additional IV contrast agent.
CT systems and their capabilities will continue to evolve rapidly in the near future; protocols will gain levels of complexity comparable to MRI; and CT systems, platforms and applications will be targeted to clinical applications, according to Carr.
For more information:
- Carr JJ. The future of cardiac CT: new technologies.
I was heartened by the good attendance at the SCCT meetings and continued avid interest in CTA by cardiologists and radiologists despite poor but improving insurance company coverage for coronary CTA, declining reimbursements and general dismal economic conditions. This speaks to the fact that coronary CTA is phenomenal technology that will only continue to improve. The positive effect of coronary CTA on clinical outcomes will take a while to prove, but there is little doubt this technology is here to stay.
– Samuel Wann, MD
Cardiology Today Section Editor