Low dose CT of the heart: a quantum leap into a new era of cardiovascular imaging

In 10 years, computed tomography coronary angiography (CTCA) has shifted from an investigational tool to clinical reality. Even though CT technologies are very advanced and widely available, a large body of evidence supporting the clinical role of CTCA is missing. The reason is that the speed of technological development has outpaced the ability of the scientific community to demonstrate the clinical utility of the technique. In addition, with each new CT generation, there is a further broadening of actual and potential applications. In this review we examine the state of the art on CTCA. In particular, we focus on issues concerning technological development, radiation dose, implementation, training and organisation.RiassuntoL’angiografia coronarica con tomografia computerizzata (CTCA) è passata in 10 anni da strumento di ricerca investigativa a strumento clinico di uso routinario. Anche se le tecnologie sono molto diffuse ed avanzate, la maggioranza delle evidenze non supportano ancora in modo forte l’utilizzo di questa metodica. La causa di questo risiede probabilmente nel fatto che la velocità dell’evoluzione tecnologica ha superato ampiamente la capacità del mondo scientifico di sviluppare dati che definiscano meglio il campo di utilizzo. A questo si aggiunge il fatto che ad ogni nuova generazione di apparecchi per la tomografia computerizzata (TC) le reali e potenziali applicazioni si espandono ulteriormente. Abbiamo revisionato lo stato dell’arte corrente sulla CTCA. In particolare, vengono approfonditi gli aspetti inerenti l’evoluzione tecnologica, la dose da radiazioni ionizzanti, l’implementazione, il training e l’organizzazione.

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