Cardiac CT – which scanner can be recommended

Vesela Stoynova, Sofia, Bulgaria has sent the following question:

Cardiac CT:
Hi EXPERTS,
We do a lot of cardio CT with 16 slice GE. We are on the way to by a new CT. I have read all advertisement about DSCT. I would like to hear your oppinion on  ustabile heart rate, extrasystole and so on. I have read the article about calcium and vessels over 6 mm in diameter, but what about coronary vessels smaller than 3 mm?
I am looking forward for your answer
Vesela

Anno Graser, MD, University of Munich:

Dear Vesela,

Generally, the main advantage of DSCT is its improved temporal resolution of 83 ms (versus 164 ms for any other CT with a rotation time of 330 ms). This is beneficial in cardiac imaging, chest pain imaging, and other applications that require high temporal resolution, especially imaging of arhythmic patients. Due to its z flying focal spot it provides a spatial resolution of 0.38 mm, which enables reconstruction of isotropic voxels; therefore, even smaller coronary branches can be visualized. Stent imaging and detection of in-stent restenosis remains challenging, even when using DSCT. Here, a dedicated kernel called B46f can be used that reduces beam hardening artifacts.
The next generation of DSCT, Somatom Definition Flash, enables sub-second whole thorax scanning and greatly improved fast scanning for long ranges in combination with great dual energy capabilities. If this is within your range of machines you are interested in, you should definitely look at this new scanner.

Yours sincerely,

Anno Graser, MD