CT imaging with ultra-high-resolution: Opportunities for cardiovascular imaging in clinical practice

Cardiovascular computed tomography (CT) angiography has become an established alternative to invasive catheter angiography. However, imaging artifacts due to partial volume effects with current systems hinder accurate evaluation of calcified or stented segments. Increased spatial resolution may allow to overcome these barriers to precise delineation of vascular disease. Recent developments in CT hardware and reconstruction have enabled CT angiography with ultra-high spatial resolution (UHRCT). In this review we aim to describe the methods to achieve greater spatial resolution in CT that are either in clinical or preclinical stage. In addition, we provide an overview of the available clinical evidence including diagnostic accuracy studies supporting improved vascular assessment with this technology. The benefits that can be gleaned from the initial experiences with UHRCT are promising. Using UHRCT, more patients may receive non-invasive characterization of coronary atherosclerosis by overcoming the limitations of current CT spatial resolution in visualizing and quantifying calcified, stented or small diameter segments. UHRCT may potentially impact existing management pathways as well as contribute to better understanding of the underlying pathophysiology of both macro- and microvascular disease.