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.

Journal: European radiology experimental
Published Date: Mar 25, 2021

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 C-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.

Authors

  • Martin J Willemink
    Departments of Radiology (L.D.H., G.M., K.H., M.K., M.J.W., A.M.S., D.F.) and Surgery (M.F.), Stanford University School of Medicine, 300 Pasteur Dr, Room S-072, Stanford, CA 94305-5105.
  • Akos Varga-Szemes
    Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (S.S.M., D.M., M.v.A., C.N.D.C., R.R.B., C.T., A.V.S., A.M.F., B.E.J., L.P.G., U.J.S.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (S.S.M., T.J.V.); Stanford University School of Medicine, Department of Radiology, Stanford, Calif (D.M.); Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.N.D.C.); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (R.R.B.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (C.T.); Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany (C.T.); Siemens Medical Solutions USA, Malvern, Pa (P.S.); and Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC (A.J.M.).
  • U Joseph Schoepf
    Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (S.S.M., D.M., M.v.A., C.N.D.C., R.R.B., C.T., A.V.S., A.M.F., B.E.J., L.P.G., U.J.S.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (S.S.M., T.J.V.); Stanford University School of Medicine, Department of Radiology, Stanford, Calif (D.M.); Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.N.D.C.); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (R.R.B.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (C.T.); Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany (C.T.); Siemens Medical Solutions USA, Malvern, Pa (P.S.); and Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC (A.J.M.).
  • Marina Codari
    1 Unit of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097 Milan, Italy.
  • Koen Nieman
    Department of Cardiology (A.C., M.L.L., J.D., K.N.).
  • Dominik Fleischmann
    Departments of Radiology (L.D.H., G.M., K.H., M.K., M.J.W., A.M.S., D.F.) and Surgery (M.F.), Stanford University School of Medicine, 300 Pasteur Dr, Room S-072, Stanford, CA 94305-5105.
  • Domenico Mastrodicasa
    Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, Charleston, SC 29425-2260 (S.S.M., D.M., M.v.A., C.N.D.C., R.R.B., C.T., A.V.S., A.M.F., B.E.J., L.P.G., U.J.S.); Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany (S.S.M., T.J.V.); Stanford University School of Medicine, Department of Radiology, Stanford, Calif (D.M.); Division of Cardiothoracic Imaging, Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (C.N.D.C.); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (R.R.B.); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich, Germany (C.T.); Department of Cardiology, Munich University Clinic, Ludwig-Maximilians-University, Munich, Germany (C.T.); Siemens Medical Solutions USA, Malvern, Pa (P.S.); and Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC (A.J.M.).

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