chapter  36
18 Pages

Full-Field Cardiac Imaging using Ultra-High Resolution Flat-Panel Volume-Computed Tomography Mannudeep K Kalra, and Thomas J Brady

ByRajiv Gupta, Soenke H Bartling

Coronary artery disease (CAD) is the leading cause of death

in the United States, accounting for approximately 540,000

myocardial infarctions, ~515,000 total deaths, and ~250,000

sudden deaths per year, most of which result from ruptured

vulnerable plaques.1 Initial diagnostic evaluation of sympto-

matic patients with suspected CAD includes risk assessment

and stress testing.2,3 Coronary angiography with diagnostic

catheterization remains the cornerstone for detecting flow-

limiting lesions (>75% stenosis) and is paramount for percu-

taneous coronary interventions (PCI). While there is

concern regarding the expense and potential complications

of diagnostic catheterization, the major limitation of coro-

nary angiography is its inability to visualize atherosclerotic

plaque within the vessel wall. This is of critical importance

since the majority of patients with acute coronary syn-

dromes (unstable angina, myocardial infarction, sudden

death) have plaques that did not have a hemodynamically

significant stenosis prior to rupture and thrombosis. Indeed,

more than 60% of myocardial infarctions are caused by

lesions, which are previously associated with a less than 50%

luminal narrowing of coronary arteries.4