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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Non-invasive coronary angiography with multi-detector computed tomography: comparison to conventional X-ray
Paul Schoenhagen1, Arthur E Stillman, Sandy S Halliburton
1Department of Radiology, Center for Integrated Non-Invasive Cardiovascular Imaging, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. schoenpl@ccf.org
Insights
Coronary artery disease (CAD) diagnosis needs new strategies beyond angiography. Coronary multidetector computed tomographic angiography (MDCTA) offers advanced imaging for early and advanced CAD, aiding treatment decisions.
Area of Science:
- Cardiovascular imaging
- Diagnostic strategies for coronary artery disease
Background:
- Coronary angiography revolutionized CAD diagnosis, enabling revascularization.
- Despite advances, CAD remains a leading cause of death, necessitating improved diagnostic tools.
- Current strategies must address both advanced and early, asymptomatic disease stages.
Purpose of the Study:
- To explore novel diagnostic strategies for coronary artery disease (CAD).
- To highlight the role of advanced imaging in characterizing early and advanced CAD.
- To emphasize the potential of atherosclerosis imaging for early intervention.
Main Methods:
- Review of historical and current coronary imaging techniques.
- Focus on coronary multidetector computed tomographic angiography (MDCTA) capabilities.
- Discussion of the integration of imaging with therapeutic devices.
Main Results:
- MDCTA enables assessment of luminal stenosis and subclinical arterial wall disease.
- MDCTA complements traditional angiography in evaluating early and advanced CAD.
- Advanced imaging supports identification of subclinical atherosclerosis for intervention.
Conclusions:
- Novel diagnostic strategies are crucial for managing coronary artery disease.
- Coronary multidetector computed tomographic angiography (MDCTA) is a valuable tool for comprehensive CAD assessment.
- Integrating advanced imaging facilitates personalized treatment and disease management.
Abstract:
Selective coronary angiography introduced clinical coronary imaging in the late 1950s. The angiographic identification of high-grade coronary lesions in patients with acute and chronic symptomatic coronary artery disease (CAD) led to the development of surgical and percutaneous coronary revascularization. However, the fact that CAD remains the major cause of death in North America and Europe demonstrates the need for novel, complementary diagnostic strategies. These are driven by the need to characterize both increasingly advanced disease stages but also early, asymptomatic disease development. Complex revascularization techniques for patients with advanced disease stages will initiate a growing demand for 3-dimensional coronary imaging and integration of imaging modalities with new mechanical therapeutic devices. An emerging focus is atherosclerosis imaging with the goal to identify subclinical disease stages as the basis for pharmacological intervention aimed at disease stabilization or reversal. Non-invasive coronary imaging with coronary multidetector computed tomographic angiography (MDCTA) allows both assessment of luminal stenosis and subclinical disease of the arterial wall. Its complementary role in the assessment of early and advanced stages of CAD is increasingly recognized.
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