What will cardiac imaging look like in 2040? It will be more automated and preventive, and CT will continue to play a major – and growing – role.
That’s according to an April 11 article in Radiology in which Dr. David Bluemke and Dr. João Lima look into the future and offer a top 10 list of major developments in cardiovascular imaging in 2040.
Cardiovascular disease carries a massive medical burden, with over 800,000 myocardial infarctions occurring annually in the US alone. By 2030 almost one-third of deaths worldwide are expected to be due to cardiovascular disease.
Multiple different imaging modalities are adept at identifying both ischemic and nonischemic heart disease, but CT has risen to the top for ischemic imaging, making “quantum” advances in the last decade thanks to its growing prowess in the coronary arteries.
CT’s advances have been so great that the modality occupies seven of the top 10 spots on Bluemke and Lima’s list. In brief, they see:
- Coronary CTA becoming totally automated, a development that will no doubt benefit AI developers like HeartFlow (see below).
- CCTA becoming a preventive tool rather than a gatekeeper to interventional cardiology (also hinted at in a recent study from Denmark). For example, CCTA will be used to track the effectiveness of statin therapy
- Photon-counting CT flexing its muscles for coronary artery evaluation and routine plaque characterization and quantification
- Next-generation cardiac CT becoming more like MRI
- Next-generation cardiac MRI becoming more like CT
They also see a major growing role for software-assisted cardiac CT with AI and other tools. Software-based automation has simplified the “postprocessing nightmares” once common with coronary CT, making it “wonderfully ordinary” to perform.
Bluemke and Lima offer a fascinating glimpse of cardiac imaging’s future. But one area they don’t touch on is whether CT’s rising prominence means radiologists will start taking back turf in heart imaging once ceded to cardiologists. Heart specialists haven’t taken over cardiac CT in the same way that they monopolized echocardiography and nuclear cardiology. Could we be seeing a renaissance of radiology in the heart?