Caption: Noninvasive computed tomography of the heart reveals diseased heart vessels.
The MUSC Health Heart and Vascular Center (HVC) produces some of the most revealing coronary computed tomography images in the U.S., having been the first in the nation to take delivery in 2014 of the industry’s most advanced technology, the SOMATOM Force (Siemen Healthcare, Forchheim, Germany). This tool is producing more than 2,000 high-fidelity noninvasive imaging studies a year at the HVC, enabling dozens of research projects that are advancing understanding of coronary artery disease. For example, the Force’s improved temporal resolution enables radiologists to better freeze cardiac movement, providing clearer images of the heart muscle so they can quantify its thickness as part of their evaluation.
Visualizing disease directly as it manifests moves medicine closer to quantifying it.
“We’re truly seeing things in great detail, such as narrowing of the heart vessels, the makeup of atherosclerotic lesions, and whether they look stable or unstable,” said U. Joseph Schoepf, M.D., Director of the Division of Cardiovascular Imaging at MUSC Health. “We’re not looking at functional sequelae as we did in the past. We’re looking at the disease directly. We can put a number on things.”
Cardiologist Sheldon E. Litwin, M.D., Alicia Spaulding-Paolozzi Professor of Cardiac Imaging, said the more quantitative data cardiologists have, the more precisely they can treat patients.
“Cardiology has been under fire for putting in too many stents, in part because the tests we’ve used to decide who gets a stent are somewhat subjective,” said Litwin. “With CT, we can now derive quantitative estimates of blood flow and use these numbers to better decide which patients should receive stents.”
As coronary computed tomographic angiography evolves, the transformation of cardiovascular disease characterization will continue, delivering better ways to diagnose and treat CAD. “We believe there is benefit to visualizing coronary artery disease directly, rather than relying on an incomplete understanding of how risk factors and surrogate markers actually translate into atherosclerosis,” said Litwin. “It’s a superior approach.”