Advanced aortic imaging: future directions

There have been dramatic advances in aortic imaging over the last decade. Some of these capabilities have been driven by the development of aortic endografts, the need for accurate measurement of aortic dimensions, and capabilities for simulating endograft placement. The development of three-dimensional (3D) reconstruction has rapidly moved from being an additional luxury item to a commodity, either packaged into advanced imaging systems or freely available as downloadable, highly advanced software such as OsiriX for the Macintosh computer. Other advances such as dynamic magnetic resonance angiography (MRA) have resulted from continuous improvement in the hardware (acquisition of signal) and software (post-processing capabilities) of these imaging systems. We are particularly intrigued by the ability of these capabilties to improve the diagnosis and treatment of aortic disease. Furthermore, there is a rapidly emerging field of creating a 3D image in the interventional suite, which can potentially be used to steer catheter-based robots in a manner never before conceived. These various components will be described below.