State-of-the-Art Cardiac CT at the Methodist Hospital

The last decade has witnessed dramatic improvements in computed tomography (CT) technology. Developments have included increasing gantry speeds, addition of multiple thin detector arrays, and more sophisticated software processing for informative image displays. The results have been improved temporal resolution, near isotropic voxels for submillimeter spatial resolution, reduced image acquisition times, and lower radiation exposures with fast scan times.1 As a result, cardiac CT has evolved into a robust technology used to noninvasively assess cardiac structure and function, determine the presence and extent of coronary artery calcification (CAC) and noncalcified plaque, hunt for coronary anomalies, and provide a noninvasive coronary angiogram for diagnosing significant coronary artery disease (CAD} in native vessels or coronary artery bypass grafts (Figures 1-3).

Accompanying research literature has evolved at an equally dizzying pace. Whether experimenting with newer CT technologies, comparing them to other cardiac imaging modalities, learning to better characterize plaque, or changing acquisition parameters to reduce radiation exposures, CT is currently generating a level of excitement that is reminiscent of the 1970s, when echocardiography rapidly came into common clinical use.2 Cardiac computed tomography has the potential to revolutionize the current practice of cardiology for CAD detection and treatment, and it is expected that its use and development will continue to accelerate in the upcoming years.

The Methodist DeBakey Heart & Vascular Center (MDHVC) is actively committed to the research, clinical activity, and teaching of cardiac CT. Under the leadership of the center's medical director of nuclear cardiology John J. Mahmarian, M.D., two board-certified nuclear-CT cardiologists have come on board and two state-of-the-art multidetector CT (MDCI) systems dedicated to cardiac imaging are now place. Also, under Mahmarian, the clinical volumes have rapidly expanded to more than 400 cardiac cases per year. Every effort is being made to design, coordinate, and participate in research trials to advance this promising field while at the same time showcasing this robust tool to clinicians.