Since 1991, CTA has to a large extent supplanted angiography-based examination of blood vessels from head to toe, thanks to the advancement of MDCT and related technologies. It's the past several years that have brought the most impressive advances in the history of CT, including faster gantry rotation, wide-area detectors, dual-source scanners, multienergy scanning, and iterative reconstruction. These techniques have made the modality indispensable in daily practice, while opening up new dimensions for CTA, according to Rubin.
"In the 1990s, it was all about migrating from angiography and plain films to volumetric assessment of stent grafts," Rubin told AuntMinnie.com. "In 2011, it's about the aortic valve and aortic root in planning valve replacement. CT seems to have to sort of reprove itself in these new paradigms, compared to more traditional 2D methods" such as echocardiography, he said.
Rubin's talk will cover major innovations such as tissue perfusion, material decomposition, flow mapping, and submillisievert CTA, highlighting new frontiers in vascular imaging with CT.
"It would seem the technology is becoming increasingly mature, having conquered all the vascular beds in the body, but there are still major steps and refinements being made," Rubin said. One is the increasing use of combined functional and anatomic information about the blood vessels, he said. Another is sophisticated evaluation of organs through tissue perfusion analysis.
More sophisticated analysis allows radiologists to "understand the significance of the vascular lesion by looking at the end organ and seeing how it is influenced [by blood flow], instead of trying to assume based on looking at the blood vessels themselves," he said.
