Role of noninvasive imaging using computed tomography for detection and quantification of coronary atherosclerosis

Abstract

Clinical cardiac computed tomography (CT) began with electron-beam CT in the early 1980s and continues now with multidetector CT in the 21st Century. The major applications of noncontrast cardiac CT are currently for the quantification of coronary artery calcium – a reliable and repeatable means to estimate atherosclerotic plaque burden. The major applications of contrast-enhanced CT (CT angiography) is for a more detailed estimation of total plaque burden by qualitatively defining noncalcified and complex plaque as well as ruling out obstructive coronary artery disease. Both of these applications are discussed and comments are made from the author regarding clinical applications based upon reviewing the published literature and through personal experience.