Cardiac CT is a low risk, low cost alternative to diagnostic X ray angiography. It can be performed safely and effectively in a cardiologist’s private office as well as in a hospital setting.
Computed tomography has been available since the 1970s and became applicable for cardiology applications in the mid 1980s when electron beam computed tomography (EBCT) was developed. However, EBCT’s limited scan volume was not sufficient for routine whole heart imaging, which restricted its widespread adoption.
Recent developments in conventional multi-slice CT technology, in particular the introduction of 64-slice scanners in 2005, enable imaging of the heart, and have sparked great interest and a rapid rise in cardiac CT diagnostic procedures, as evidenced by numerous publications, conference presentations, and training programs.
The emerging task of CT in cardiology is imaging of the coronary arteries and serving as the “gate keeper” to cardiac catheterization labs. The majority of heart diseases ensue from coronary artery stenoses caused by plaque or thrombi and are detected by invasive and costly cardiac catheterization procedures. Typically, 30%-40% of catheterization procedures are diagnostic only; the rest involve therapeutic intervention (e.g. stent delivery). CT imaging is non-invasive and relatively inexpensive, and thus offers a less stressful and lower cost alternative to cardiac catheterization. Recent studies demonstrate that cardiac-CT increases ER efficiency by reducing patient's length of hospitalization with no elevated costs.
In the longer term, management of coronary artery disease will rely in part on early diagnosis of vulnerable patients and pharmacological rather than surgical treatment. Here, the role of CT as a non-invasive technique for plaque assessment and follow-up is crucial for success. Cardiac CT is effective for additional cardiology procedures and can successfully replace other imaging technologies in certain tests. Cardiac CT is therefore expected to play an increasing role throughout diagnostic cardiology.