Emerging methods for the characterization of ischemic heart disease: ultrafast Doppler angiography, micro-CT, photon-counting CT, novel MRI and PET techniques, and artificial intelligence

Abstract

After an ischemic event, disruptive changes in the healthy myocardium may gradually develop and may ultimately turn into fibrotic scar. While these structural changes have been described by conventional imaging modalities mostly on a macroscopic scale—i.e., late gadolinium enhancement at magnetic resonance imaging (MRI)—in recent years, novel imaging methods have shown the potential to unveil an even more detailed picture of the postischemic myocardial phenomena. These new methods may bring advances in the understanding of ischemic heart disease with potential major changes in the current clinical practice. In this review article, we provide an overview of the emerging methods for the non-invasive characterization of ischemic heart disease, including coronary ultrafast Doppler angiography, photon-counting computed tomography (CT), micro-CT (for preclinical studies), low-field and ultrahigh-field MRI, and 11C-methionine positron emission tomography. In addition, we discuss new opportunities brought by artificial intelligence, while addressing promising future scenarios and the challenges for the application of artificial intelligence in the field of cardiac imaging.

Recent technologies in cardiac imaging

“…Spectral CT technology provides diverse views from a single scan instead of scanning a patient several times using various energies to focus on different tissue types. This software can also accentuate or remove chemical compounds solely based on their atomic number (e.g., iodine, calcium) ( 101 ). The PCDs count the number of incoming photons and measure this photon energy, thus resulting in a greater contrast-to-noise ratio, increased spatial resolution, multi-energy ability, and absence of electronic noise ( 102 ).…”

Understanding Human Body Maintenance, Protection, and Modification: Antibodies, Genetics, Stem Cells and Connected Artificial Intelligence Applications—Where Are We?

“…Fast item identification and comparison, data extraction, as well as calculation algorithms in acquired data amounts are the domains of these applications. Further, the applied algorithms help to analyze large databases, either by logic, [49]. The validity, reliability, effectiveness, and applicability of the applications have to be clarified for the specific setting [50].…”

Low-dose coronary calcium scoring CT using a dedicated reconstruction filter for kV-independent calcium measurements

“…For mechanical CT scanners, the standard tube voltage is 120 kVp. Contemporary CT scanners with more powerful Röntgen tubes can image the heart at substantially lower tube potentials, which reduces patient radiation exposure without sacrificing image quality [5][6][7][8][9]. The standard tube potential for calcium imaging has nevertheless remained at 120 kVp for sake of reproducibility of the Agatston score [10].…”