U. Joseph Schoepf, MD

During my first eight years of performing and interpreting cardiac multislice CT, up to 2006, our mantra was always that slower heart rates improve diagnostic image quality. Aside from image quality, slow heart rates also traditionally translated into lower patient radiation exposure. Our most elegant tool for radiation protection at cardiac CT was ECG-dependent tube current modulation, which applies the full nominal tube output only during diastole. This tool, unfortunately, has been limited for the longest time to patients with slow and steady heart rates.

Accurate and reproducible assessment of left ventricular function is crucial for differential diagnosis, risk stratification, treatment planning, and predicting prognosis in patients with heart disease. Evaluation of global and regional LV wall motion, valvular function, myocardial mass, and, in some cases, right ventricular function produces valuable ancillary pieces of clinical information that can be obtained from a contrast-enhanced multislice CT scan.

No technological advance for imaging the thorax has had so profound an impact on the visualization and management of data as multislice CT. Its fast acquisition times and higher resolution have forever changed imaging of the lung, an organ whose dynamic nature demands rapid acquisition and whose complex anatomy demands isotropic resolution for fine anatomic detail and true 3D analysis. MSCT allows shorter breath-holds, fewer breathing and motion artifacts, and reduced contrast delivery for CT angiography studies. The improved anatomic detail clarifies pulmonary anatomy and detects change as an indicator of disease.