New advances in cardiac computed tomography

PURPOSE OF REVIEWMultidetector computed tomography has been growing in every way possible. The test is becoming more common in clinical practice. It has breached the public consciousness and is being asked for by name. Research in the field is accelerating. The technology is improving, as is our skill at interpretation. There have been hundreds of publications on the subject over the past year. We will address three of the most important recent areas of focus. RECENT FINDINGSMultidetector computed tomography has been touted as a possible ‘triple rule-out’ for myocardial infarction, pulmonary embolus, and aortic dissection, with an eye to improving emergency department efficiency and efficacy. A recent study has shown that, at least in low-risk patients, the triple rule-out is as safe as standard of care diagnosis, and saves considerable time and expense. Calcium scoring, hotly debated for years, has received approval from both the American Heart Association and American College of Cardiology as a screening test under certain circumstances. The 64-detector scanner has shown improvement over the 16-detector scanner. SUMMARYThese developments indicate that multidetector computed tomography has more uses than previously realized. They also indicate that we have much more work to do before we can claim to have fully utilized this technology.