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Imaging of the heart with computed tomography

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Abstract

Imaging of the heart with computed tomography (CT) was already introduced in the 1980Îs and has meanwhile entered clinical routine as a consequence of the rapid evolution of CT technology during the last decade. In this review article, we give an overview on the technology and clinical performance of different CT-scanner generations used for cardiac imaging, such as Electron Beam CT (EBCT), single-slice CT und multi-detector row CT (MDCT) with 4, 16 and 64 simultaneously acquired slices. We identify the limitations of current CT-scanners, indicate potential of improvement and discuss alternative system concepts such as CT with area detectors and dual source CT (DSCT).

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References

  1. Achenbach S, Moshage W, Ropers D, Bachmann K (1998) Curved multiplanar reconstructions for the evaluation of contrast-enhanced electron-beam CT of the coronary arteries. AJR 170:895–899

    PubMed  CAS  Google Scholar 

  2. Achenbach S, Ulzheimer S, Baum U et al (2000) Noninvasive coronary angiography by retrospectively ECG-gated multi-slice spiral CT. Circulation 102:2823–2828

    PubMed  CAS  Google Scholar 

  3. Achenbach S, Giesler T, Ropers D, Ulzheimer S, Derlien H, Schulte C, Wenkel E, Moshage W, Bautz W, Daniel WG, Kalender WA, Baum U (2001) Contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Ciculation 103:2535–2538

    CAS  Google Scholar 

  4. Achenbach S, Ropers D, Pohle F-K, Raaz D, von Erffa J, Yilmaz A, Muschiol G, Daniel WG (2005) Detection of coronary artery stenoses using multi-detector CT with 16 × 0,75 collimation and 375 ms rotation. Eur Heart J 26:1978–1986

    Article  PubMed  Google Scholar 

  5. Achenbach S, Ropers D, Kuettner A, Flohr T, Ohnesorge B, Bruder H, Theessen H, Karakaya M, Daniel WG, Bautz W, Kalender WA, Anders K (2006) Contrast-enhanced coronary artery visualization by dual-source computed tomography-initial experience. Eur J Radiol 57(3):331–335

    Article  PubMed  Google Scholar 

  6. Albert TSE, Kim R, Judd RM (2006) Assessment of no-reflow regions using cardiac MRI. Basic Res Cardiol 101:383–390

    Article  PubMed  Google Scholar 

  7. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. JACC 15:827–832

    PubMed  CAS  Google Scholar 

  8. Bahner M, Boese J, Lutz A et al (1999) Retrospectively ECG-gated spiral CT of the heart and lung. Eur Radiol 9:106–109

    Google Scholar 

  9. Becker C, Knez A, Jakobs T et al (1999) Detection and quantification of coronaryartery calcification with electron-beam and conventional CT. Eur Radiol 9:620–624

    Article  PubMed  CAS  Google Scholar 

  10. Becker C, Knez A, Ohnesorge B, Schöpf U, Reiser M (2000) Imaging of non calcified coronary plaques using helical CT with retrospective EKG gating. AJR 175:423–424

    PubMed  CAS  Google Scholar 

  11. Becker CR, Kleffel T, Crispin A, Knez A, Young Y, Schöpf UJ, Haberl R, Reiser MF (2001) Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. Am J Roentgenol 176:1295–1298

    CAS  Google Scholar 

  12. Becker CR, Knez A, Leber A, Treede H, Ohnesorge B, Schoepf UJ, Reiser MF (2002) Detection of coronary artery stenoses with multislice helical CT angiography. JCAT 26(5):750–755

    Google Scholar 

  13. Budoff M, Georgiou D, Brody A et al (1996) Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. Circulation 93:898–904

    PubMed  CAS  Google Scholar 

  14. Cademartiri F, Mollet NR, Runza G, Baks T, Midiro M, McFadden EP, Flohr TG, Ohnesorge B, de Feyter PJ, Krestin GP (2006) Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing. AJR 186:634–638

    Article  PubMed  Google Scholar 

  15. Coles DR, Wilde P, Oberhoff M, Rogers CA, Karsch KR, Baumbach A (2006) Multislice computed tomography coronary angiography in patients admitted with a suspected cute coronary syndrome. Int J Cardiovasc Imaging 23(5):603–614

    Article  PubMed  Google Scholar 

  16. Dewey M, Laule M, Krug L et al (2004) Multisegment and halfscan reconstruction of 16-slice computed tomography for detection of coronary artery stenoses. Invest Radiol 39:223–229

    Article  PubMed  Google Scholar 

  17. Dewey M, Telge F, Schnapauff D, Laule M, Borges AC, Wernecke K-D, Schink T, Baumann G, Rutsch W, Rogalla P, Taupitz M, Hamm B (2006) Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging. Ann Intern Med 145:407–415

    PubMed  Google Scholar 

  18. Dorgelo J, Willems TP, Geluk CA, van Ooijen PMA, Zijlstra F, Oudkerk M (2005) Multidetector computed tomography guided treatment strategy in patients with non-ST elevation acute coronary syndromes: a pilot study. Eur Radiol 15:708–713

    Article  PubMed  CAS  Google Scholar 

  19. Endo M, Mori S, Kandatsu S, Tanada S, Sugihara N, Saito Y, Adachia A, Miyazaki H (2005) Development of real 4D CT with real-time reconstruction and display. IEEE Nucl Sci Symp Conf Rec 5:2603–2606

    Article  Google Scholar 

  20. Flamm SD (1998) Coronary artery calcium screening: ready for prime time? Radiology 208:571–572

    PubMed  CAS  Google Scholar 

  21. Flohr T, Bruder H, Stierstorfer K, Simon J, Schaller S, Ohnesorge B (2002) New technical developments in multislice CT, Part 2: sub-millimeter 16-slice scanning and increased gantry rotation speed for cardiac imaging. Röfo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174:1022–1027

    Article  PubMed  CAS  Google Scholar 

  22. Flohr T, Schoepf UJ, Kuettner A, Halliburton S, Bruder H, Suess C, Schmidt B, Hofmann L, Yucel EK, Schaller S, Ohnesorge B (2003) Advances in Cardiac Imaging with 16-section CT-Systems. Acad Radiol 10:386–401

    Article  PubMed  Google Scholar 

  23. Flohr T, Ohnesorge B, Bruder H, Stierstorfer K, Simon J, Suess C, Schaller S (2003) Image reconstruction and performance evaluation for ecg-gated spiral scanning with a 16-slice CT system. Med Phys 30(10):2650–2662

    Article  PubMed  Google Scholar 

  24. Flohr T, Stierstorfer K, Raupach R, Ulzheimer S, Bruder H (2004) Performance evaluation of a 64-Slice CT-system with z-flying focal spot. Röfo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 176:1803–1810

    Article  PubMed  CAS  Google Scholar 

  25. Flohr TG, Stierstorfer K, Ulzheimer S, Bruder H, Primak AN, McCollough CH (2005) Image reconstruction and image quality evaluation for a 64-slice CT scanner with z-flying focal spot. Med Phys 32(8):2536–2547

    Article  PubMed  CAS  Google Scholar 

  26. Flohr TG, McCollough CH, Bruder H, Petersilka M, Gruber K, Süß C, Grasruck M, Stierstorfer K, Krauss B, Raupach R, Primak AN, Küttner A, Achenbach S, Becker C, Kopp A, Ohnesorge BM (2006) First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol 16(2):256–268

    Article  PubMed  Google Scholar 

  27. Gerber BL, Coche E, Pasquet A, Ketelslegers E, Vancraeynest D, Grandin C, van Beers BE, Vanoverschelde J-LJ (2005) Coronary artery stenosis: direct comparison of four-section multi-detector row CT and 3D Navigator MR imaging for detection-initial results. Radiology 234:98–108

    Article  PubMed  Google Scholar 

  28. Ghostine S, Caussin C, Daoud B, Habis M, Perrier E, Pesenti-Rossi D, Sigal-Cinqualbre A, Angel C-Y, Lancelin B, Capderou A, Paul J-F (2006) Non-invasove detection of coronary artery disease in patients with left bundle branch block using 64-slice computed tomography. JACC 48(10):1929–1934

    PubMed  Google Scholar 

  29. Halliburton SS, Stillman AE, Flohr T, Ohnesorge B, Obuchowski N, Lieber M, Karim W, Kuzmiak S, Kasper JM, White RD (2003) Do segmented reconstruction algorithms for cardiac multi-slice computed tomography improve image quality? Herz 28(1):20–31

    Article  PubMed  Google Scholar 

  30. Hoffmann U, Moselewski F, Cury RC, Ferencik M, Jang I, Diaz LJ, Abbara S, Brady TJ, Achenbach S (2004) Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease. Circulation 110:2638–2643

    Article  PubMed  Google Scholar 

  31. Hoffmann MHK, Shi H, Schmitz BL, Schmid FT, Lieberknecht M, Schulze R, Ludwig B, Kroschel U, Jahnke N, Haerer W, Brambs H-J, Aschoff AJ (2005) Noninvasive coronary angiography with multislice computed tomography. JAMA 293:2471–2478

    Article  PubMed  CAS  Google Scholar 

  32. Ito H, Komura N, Iwakura K, Kawano S, Okamura A, Fujii K (2006) Combination study of myocardial perfusion and left ventricular filling provides an excellent prediction of clinical outcomes in patients with reperfused myocardial infarction. Basic Res Cardiol 101:400–407

    Article  PubMed  CAS  Google Scholar 

  33. Johnson TRC, Nikolaou K, Wintersperger BJ, Leber AW, von Ziegler F, Rist C, Buhmann S, Knez A, Reiser MF, Becker CR (2006) Dual source cardiac CT imaging: initial experience. Eur Radiol 16:1409–1415

    Article  PubMed  Google Scholar 

  34. Juergens KU, Grude M, Fallenberg EM, Heindel W, Fischbach R (2002) Using ECG-gated multidetector CT to evaluate global left ventricular myocardial function in patients with coronary artery disease. Am J Roentgenol 179:1545–1550

    Google Scholar 

  35. Kachelriess M, Kalender W (1998) Electrocardiogram-correlated image reconstruction from subsecond spiral computed tomography scans of the heart. Med Phys 25:2417–2431

    Article  PubMed  CAS  Google Scholar 

  36. Kachelriess M, Ulzheimer S, Kalender W (2000) ECG-correlated image reconstruction from subsecond multi-slice spiral CT scans of the heart. Med Phys 27:1881–1902

    Article  PubMed  CAS  Google Scholar 

  37. Kaul S (2006) Evaluating the ‘no reflow’ phenomenon with myocardial contrast echocardiography. Basic Res Cardiol 101:391–399

    Article  PubMed  Google Scholar 

  38. Kefer JM, Coche E, Vanoverschelde J-LJ, Gerber BL (2007) Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis. Eur Radiol 17:87–96

    Article  PubMed  Google Scholar 

  39. Knez A, Becker CR, Leber A, Ohnesorge B, Becker A, White C, Haberl R, Reiser MF, Steinbeck G (2001) Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. AJC 88:1191–1194

    CAS  Google Scholar 

  40. Kondo C, Mori S, Endo M, Kusakabe K, Suzuki N, Hattori A, Kusakabe M (2005) Real-time volumetric imaging of human heart without electrocardiographic gating by 256-detector row computed tomography: initial experience. J Comput Assist Tomogr 29(5):694–698

    Article  PubMed  Google Scholar 

  41. Kopp A, Schröder S, Küttner A et al (2001) Coronary arteries: retrospectively ECG-gated multidetector row CT angiography with selective optimization of the image reconstruction window. Radiology 221:683–688

    Article  PubMed  CAS  Google Scholar 

  42. Kopp AF, Ohnesorge B, Becker C, Schröder S, Heuschmid M, Küttner A, Kuzo R, Claussen CD (2002) Reproducibility and accuracy of coronary calcium measurement with multidetector-row versus electron beam CT. Radiology 225:113–119

    Article  PubMed  CAS  Google Scholar 

  43. Kuettner A, Trabold T, Schroeder S, Feyer A, Beck T, Brueckner A, Heuschmid M, Burgstahler C, Kopp AF, Claussen CD (2004) Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology. JACC 44:1230–1237

    PubMed  Google Scholar 

  44. Kuettner A, Kopp AF, Schroeder S, Rieger T, Brunn J, Meisner C, Heuschmid M, Trabold T, Burgstahler C, Martensen J, Schoebel W, Selbmann H-K, Claussen CD (2004) Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with angiographically proven coronary artery disease. JACC 43(5):831–839

    PubMed  Google Scholar 

  45. Kuettner A, Beck T, Drosch T et al (2005) Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution. JACC 45:123–127

    PubMed  Google Scholar 

  46. Leber AW, Knez A, Becker C, Becker A, White C, Thilo C, Reiser M, Haberl R, Steinbeck G (2003) Non-invasive intravenous coronary angiography using electron beam tomography and multislice computed tomography. Heart 89:633–639

    Article  PubMed  CAS  Google Scholar 

  47. Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S, Wintersperger B, Reiser M, Becker CR, Steinbeck G, Boekstegers P (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. JACC 46(1):147–154

    PubMed  Google Scholar 

  48. Leschka S, Alkadhi H, Plass A, Desbiolles L, Grünenfelder J, Marincek B, Wildermuth S (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487

    Article  PubMed  Google Scholar 

  49. Martuscelli E, Romagnoli A, D’Eliseo A, Razzini C, Tomassini M, Sperandio M, Simonetti G, Romeo F (2004) Accuracy of thin-slice computed tomography in the detection of coronary stenoses. Eur Heart J 25:1043–1048

    Article  PubMed  Google Scholar 

  50. McCollough CH, Zink FE (1994) The technical design and performance of ultrafast computed tomography. Radiol Clin North Am 32(3):521–536

    PubMed  CAS  Google Scholar 

  51. McCollough CH, Zink FE, Morin R (1994) Radiation dosimetry for electron beam CT. Radiology 192(3):637–643

    PubMed  CAS  Google Scholar 

  52. McCollough CH, Kanal KM, Lanutti N, Ryan KJ (1999) Experimental determination of section sensitivity profiles and image noise in electron beam computed tomography. Med Phys 26(2):287–295

    Article  PubMed  CAS  Google Scholar 

  53. McCollough CH, Primak AN, Saba O, Bruder H, Stierstorfer K, Raupach R, Suess C, Schmidt B, Ohnesorge BM, Flohr TG (2007) Dose performance of a 64-channel dual-source CT scanner. Radiology 243:775–784

    Article  PubMed  Google Scholar 

  54. Meijboom WB, Mollet NR, van Mieghem CA, Weustink AC, Pugliese F, van Pelt N, Cademartiri F, Vourvouri E, de Jaegere P, Krestin G P, de Feyter PJ (2007) 64-slice computed tomography coronary angiography in patients with non-ST elevation acute coronary syndrome. Heart 93(11):1386–1392

    Article  PubMed  Google Scholar 

  55. Mollet NR, Cademartiri F, Nieman K, Saia F, Lemos PA, McFadden EP, Pattynama PMT, Serruys PW, Krestin GP, de Feyter PJ (2004) Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris. JACC 43(12):2265–2270

    PubMed  Google Scholar 

  56. Mollet NR, Cademartiri F, van Mieghem CAG, Runza G, McFadden EP, Baks T, Serruys PW, Krestin GP, de Feyter PJ (2005) High-resolution spiral computed tomography coronary angiography in patients referred for diagnostc conventional coronary angiography. Circulation 112:2318–2323

    Article  PubMed  Google Scholar 

  57. Mollet NR, Cademartiri F, Krestin GP, McFadden EP, Arampatzis CA, Serruys PW, de Feyter PJ (2005) Improved diagnostic accuracy with 16-row multislice computed tomography coronary angiography. JACC 45:128–132

    PubMed  Google Scholar 

  58. Morghan-Hughes GJ, Marshall AJ, Roobottom CA (2003) Multislice computed tomographic coronary angiography: experience in a UK centre. Clin Radiol 58(5):378–383

    Article  Google Scholar 

  59. Morgan-Hughes GJ, Roobottom CA, Owens PE, Marshall AJ (2005) Highly accurate coronary angiography with submillimetre, 16-slice computed tomography. Heart 91:308–313

    Article  PubMed  CAS  Google Scholar 

  60. Mori S, Endo M, Tsunoo T, Kandatsu S, Tanada S, Aradate H et al (2004) Physical performance evaluation of a 256-slice CT-scanner for dour-dimensional imaging. Med Phys 31(6):1348–1356

    Article  PubMed  Google Scholar 

  61. Mori S, Endo M, Obata T, Tsunoo T, Susumu K, Tanada S (2006) Properties of the prototype 256-row (cone beam) CT scanner. Eur Radiol 16(9):2100–2108

    Article  PubMed  Google Scholar 

  62. Mori S, Kondo C, Suzuki N, Hattori A, Kusakabe M, Endo M (2006) Volumetric coronary angiography using the 256-detector row computed tomography scanner: comparison in vivo and in vitro with porcine models. Acta Radiol 47(2):186–191

    Article  PubMed  CAS  Google Scholar 

  63. Nieman K, Oudkerk M, Rensing BJ, van Ooijen P, Munne A, van Geuns RJ, de Feyter PJ (2001) Coronary angiography with multi-slice computed tomography. Lancet 357:599–603

    Article  PubMed  CAS  Google Scholar 

  64. Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PMT, de Feyter PJ (2002) Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 106:2051–2054

    Article  PubMed  Google Scholar 

  65. Nieman K, Rensing BJ, van Geuns R-JM et al (2002) Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Am J Cardiol 89:913–918

    Article  PubMed  Google Scholar 

  66. Nieman K, Rensing BJ, van Geuns R-JM, Vos J, Pattynama PMT, Krestin GP, Serruys PW, de Feyter PJ (2002) Non-invasive coronary angiography with multislice spiral computed tomography: impact of heart rate. Heart 88:470–474

    Article  PubMed  CAS  Google Scholar 

  67. Ohnesorge B, Flohr T, Becker C, Kopp A, Schoepf U, Baum U, Knez A, Klingenbeck Regn K, Reiser M (2000) Cardiac imaging by means of electro-cardiographically gated multisection spiral CT—initial experience. Radiology 217:564–571

    PubMed  CAS  Google Scholar 

  68. Pugliese F, Mollet NRA, Runza G, van Mieghem C, Meijboom WB, Malagutti P, Baks T, Krestin GP, de Feyter PJ, Cademartiri F (2006) Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol 16:575–582

    Article  PubMed  Google Scholar 

  69. Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. JACC 46(3):552–557

    PubMed  Google Scholar 

  70. Ritman E, Kinsey J, Robb R, Gilbert B, Harris L, Wood E (1980) Three-dimensional imaging of heart, lungs, and circulation. Science 210:273–280

    Article  PubMed  CAS  Google Scholar 

  71. Robb R, Ritman E (1979) High speed synchronous volume computed tomography of the heart. Radiology 133:655–661

    PubMed  CAS  Google Scholar 

  72. Ropers D, Baum U, Pohle K, Anders K, Ulzheimer S, Ohnesorge B, Schlundt C, Bautz W, Daniel WG, Achenbach S (2003) Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 107:664–666

    Article  PubMed  Google Scholar 

  73. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S (2006) Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. Eur Radiol 16(12):2739–2747

    Article  PubMed  Google Scholar 

  74. Schroeder S, Kopp A, Baumbach A, Meisner C, Kuettner A, Georg C, Ohnesorge B, Herdeg C, Claussen C, Karsch K (2001) Noninvasive detection and evaluation of atherosclerotic coronary plaques with multi-slice computed tomography. JACC 37(5):1430–1435

    PubMed  CAS  Google Scholar 

  75. Stanford W, Rumberger J (1992) Ultrafast computed tomography in cardiac imaging: principles and practise. Futura Publishing Company, New York

    Google Scholar 

  76. Taguchi K, Anno H (2000) High temporal resolution for multi-slice helical computed tomography. Med Phys 27:861–872

    Article  PubMed  CAS  Google Scholar 

  77. Vogl TJ, Abolmaali ND, Diebold T, Engelmann K, Ay M, Dogan S, Wimmer-Greinecker G, Moritz A, Herzog C (2002) Techniques for the detection of coronary atherosclerosis: multi-detector row CT coronary angiography. Radiology 223:212–220

    Article  PubMed  Google Scholar 

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Conflict of Interest

Thomas Flohr is an employee of Siemens Healthcare, Forchheim, Germany. Bernd Ohnesorge is an employee of Siemens Limited, China.

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  1. Siemens Medical Solutions, Forchheim, Germany

    Thomas G. Flohr & Bernd M. Ohnesorge

  2. Dept. of Diagnostic Radiology, Eberhard-Karls-Universität Tübingen, Tübingen, Germany

    Thomas G. Flohr

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Appendix

Appendix

Table 3 Meta-analysis of 36 clinical studies on the detection of significant coronary artery stenoses (>50% in diameter) with the different generations of CT-systems in comparison with conventional catheter angiography, on a per-segment basis
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Flohr, T.G., Ohnesorge, B.M. Imaging of the heart with computed tomography. Basic Res Cardiol 103, 161–173 (2008). https://doi.org/10.1007/s00395-008-0699-y

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