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World J Cardiol. Dec 26, 2013; 5(12): 473-483
Published online Dec 26, 2013. doi: 10.4330/wjc.v5.i12.473
Coronary CT angiography: Diagnostic value and clinical challenges
Akmal Sabarudin, Zhonghua Sun
Akmal Sabarudin, Diagnostic Imaging and Radiotherapy Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
Zhonghua Sun, Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Western Australia 6845, Australia
Author contributions: Both authors contributed equally to this paper.
Correspondence to: Zhonghua Sun, Associate Professor, Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, GPO Box, U1987 Perth, Western Australia 6845, Australia. z.sun@curtin.edu.au
Telephone: +61-8-92667509 Fax: +61-8-92662377
Received: July 24, 2013
Revised: September 25, 2013
Accepted: October 11, 2013
Published online: December 26, 2013
Processing time: 155 Days and 16.6 Hours
Abstract

Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

Keywords: Coronary artery disease; Coronary CT angiography; Diagnostic value; Multislice CT; Artifacts

Core tip: Coronary Computed tomography (CT) angiography represents the technical evolution in cardiac imaging due to its high diagnostic value in coronary artery disease as a less invasive technique. Diagnostic performance of coronary CT angiography is significantly enhanced with the development of multislice CT scanners, ranging from 4-slice to 64- and post-64 slice scanners. This article provides readers with a comprehensive review of the diagnostic value of coronary CT angiography according to different generations of multislice CT, with limitations and challenges being addressed.