25 years of cardiac CT imaging: past, present, and future

A brief summary of past, present, and future of cardiac CT is given. PAST: As long as the CT exposure time was in a range between 1 and 5 s, it was only possible to image cardiac morphology. At that time, we have learned the diagnostic criteria of transverse cardiac imaging especially in the field of pericardial diseases. Diagnostic criteria of constrictive pericarditis were developed which were superior to all other imaging modalities as it became possible to image the complete cardiac structures and the organs of the chest simultaneously without overlap and without any anatomic or patient limitation and observer-independent. A new concept of approach and therapy of this disease was developed, and in those institutions where this method was applied, the mortality from pericardiectomy could be essentially reduced and the surgical outcome results improved.

The presence is characterized by an increase in functional imaging as there is a continuous reduction of the exposure time using the advanced multi-slice and multi-detector and electron-beam CT technology which is reflected by the integration of these methods in the daily evaluation of coronary heart disease. Coronary atherosclerosis, coronary arteries, functional parameters, and myocardial perfusion can be evaluated qualitatively and quantitatively.

Technically, in the future further shortening of the exposure time and the introduction of flat detectors for real-time volume imaging may be expected with changes of diagnostic and therapeutic algorithms.