High-tech scans could detect heart disease years before symptoms appear

By Mark Waghorn via SWNS

High-tech scans could detect heart disease in at-risk patients, scientists say.

Hundreds of thousands of middle-aged Britons could benefit every year from the breakthrough.

Ultra-high-resolution CT technology enables excellent image quality and accurate diagnosis of coronary artery disease.

It's non-invasive, spotting dangers years before they occur.

Currently, coronary CT angiography (CCTA) is highly effective for ruling out coronary artery disease in patients at low or intermediate risk.

But screening a high-risk population is difficult due to a high prevalence of calcifications.

They tend to 'bloom', making them appear more extensive than they really are - resulting in false-positive results.

Lead author Dr. Muhammad Hagar, of the University of Freiburg in Germany, said: "Consequently, patients may undergo unnecessary, often invasive, testing.

"This is the reason why current guidelines do not recommend using CCTA in high-risk individuals."

The radical new tool uses a photon-counting detector.

The first extensive study of its kind compared diagnostic accuracy with the reference standard of invasive coronary angiography (ICA) in 68 patients.

Participants had severe aortic valve stenosis, a common, serious valve disease that reduces or blocks blood flow from the heart.

UHR-CCTA was highly sensitive and specific for coronary artery disease detection.

It delivered a median overall image quality score of 1.5 on the 5-point Likert scale, where one is excellent and five is non-diagnostic.

Almost 80 per cent of segments rated as good or excellent. It suggests the technique may soon be available to high-risk patients.

Dr. Hagar said: "It appears that the spectrum of patients benefiting from undergoing non-invasive CCTA has been significantly broadened by photon-counting detector technology.

"This is excellent news for these patients and the imaging community."

The high resolution of UHR-CCTA results from a greater number of emitted photons.

This also increases radiation exposure compared with conventional CT scanners. The technology is at a very early stage.

Researchers are developing methods to reduce the amount of radiation exposure.

Dr. Hagar said: "Currently, the technique is feasible for high-risk patients, in whom the benefits outweigh the risks, but should not be applied to all patients referred for cardiac CT imaging."

Photon-counting CT is relatively scarce worldwide. Experts anticipate the technology will become more prevalent in the next 10 years.

Dr. Hagar said: "At the University of Freiburg, we had the privilege to work with the technology since its introduction and I am convinced that photon-counting CT is the beginning of a new generation of CT scanners, similar to the introduction to multislice CT 30 years ago."

The researchers are exploring the diagnostic ability of photon-counting CT technology in other clinical scenarios such as oncological imaging.

In the field of cardiac imaging, they are expanding their research to include subgroups for whom CT imaging is currently not feasible, such as patients with coronary stents.

They also are looking into heart muscle assessment with photon-counting CT.

Early findings suggest the technology, described in the journal Radiology, may improve soft tissue resolution. This would greatly benefit disease characterization.

Dr. Hagar added: "For me, these are exciting times, and it is just great to be part of a very active group working with this new technology."