Usefulness of multidetector computed tomography for noninvasive evaluation of coronary arteries in asymptomatic patients

S. David Gertz*, Paul Cherukuri, Bernhard G. Bodmann, Gregory Gladish, Wayne T. Wilner, Jodie L. Conyers, Ibrahim Aboshady, Mohammad Madjid, Deborah Vela, Serhiy Lukovenkov, Manos Papadakis, Donald Kouri, Reza Mohammadi Mazraeshahi, Lorraine Frazier, Alireza Zarrabi, Donald Elrod, James T. Willerson, S. Ward Casscells

*Corresponding author for this work

Research output: Contribution to journalComment/debate

18 Scopus citations

Abstract

This editorial addresses the capabilities, limitations, and potential of multidetector computed tomography (MDCT) for the noninvasive evaluation of coronary arteries in asymptomatic patients. The quantification of coronary calcium with MDCT correlates highly with that obtained by electron-beam computed tomography, but to date, neither has the capability of assessing the distribution of various morphologic patterns of calcium and their relation to other "soft" plaque components. Although MDCT can assess the thickness of the atherosclerotic wall and can readily identify calcific deposits, further plaque characterization (e.g., lipid pools and fibrous tissue), a prerequisite for the identification of most vulnerable lesions, is not yet a workable reality, even with the 64-slice machines in their current configuration. The noninvasive identification by MDCT of plaque components subtending vulnerable lesions will require additional improvement in the primary instrumentation, the use of hybrid constructs (e.g., with positron emission tomography and magnetic resonance imaging), the development of novel methods of post-acquisitional analysis to extract latent images of plaque components (e.g., signal analysis based on 3-dimensional wavelets), or the adaptation of molecular imaging techniques at the cell and gene levels to computed tomography. Such unique approaches may soon contribute a long list of additional parameters that could be evaluated on a noninvasive basis as predictors of acute coronary syndromes and overall patient vulnerability.

Original languageEnglish
Pages (from-to)287-293
Number of pages7
JournalAmerican Journal of Cardiology
Volume97
Issue number2
DOIs
StatePublished - 15 Jan 2006

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