title: Usefulness of multidetector computed tomography for noninvasive evaluation of coronary arteries in asymptomatic patients.
abstract: This editorial addresses the capabilities, limitations, and potential of multidetector computed tomography (MDCT) for the noninvasive evaluation of coronary arteries in asymptomatic patients. The quantification of coronary calcium with MDCT correlates highly with that obtained by electron-beam computed tomography, but to date, neither has the capability of assessing the distribution of various morphologic patterns of calcium and their relation to other "soft" plaque components. Although MDCT can assess the thickness of the atherosclerotic wall and can readily identify calcific deposits, further plaque characterization (e.g., lipid pools and fibrous tissue), a prerequisite for the identification of most vulnerable lesions, is not yet a workable reality, even with the 64-slice machines in their current configuration. The noninvasive identification by MDCT of plaque components subtending vulnerable lesions will require additional improvement in the primary instrumentation, the use of hybrid constructs (e.g., with positron emission tomography and magnetic resonance imaging), the development of novel methods of post-acquisitional analysis to extract latent images of plaque components (e.g., signal analysis based on 3-dimensional wavelets), or the adaptation of molecular imaging techniques at the cell and gene levels to computed tomography. Such unique approaches may soon contribute a long list of additional parameters that could be evaluated on a noninvasive basis as predictors of acute coronary syndromes and overall patient vulnerability.
authors.forename: S David
authors.initials: SD
authors.lastname: Gertz
authors.forename: Paul
authors.initials: P
authors.lastname: Cherukuri
authors.forename: Bernhard G
authors.initials: BG
authors.lastname: Bodmann
authors.forename: Gregory
authors.initials: G
authors.lastname: Gladish
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Wilner
authors.forename: Jodie L
authors.initials: JL
authors.lastname: Conyers
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aboshady
authors.forename: Mohammad
authors.initials: M
authors.lastname: Madjid
authors.forename: Deborah
authors.initials: D
authors.lastname: Vela
authors.forename: Serhiy
authors.initials: S
authors.lastname: Lukovenkov
authors.forename: Manos
authors.initials: M
authors.lastname: Papadakis
authors.forename: Donald
authors.initials: D
authors.lastname: Kouri
authors.forename: Reza Mohammadi
authors.initials: RM
authors.lastname: Mazraeshahi
authors.forename: Lorraine
authors.initials: L
authors.lastname: Frazier
authors.forename: Alireza
authors.initials: A
authors.lastname: Zarrabi
authors.forename: Donald
authors.initials: D
authors.lastname: Elrod
authors.forename: James T
authors.initials: JT
authors.lastname: Willerson
authors.forename: S Ward
authors.initials: SW
authors.lastname: Casscells
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000737:chemistry*; D006801:Humans; D014057:Tomography, X-Ray Computed / Q000379:methods*