New 256-slice CT scanner to predict potential heart attack in one second

What can you do in one second? Snap your fingers, blink your eyes, or get a diagnostic scan on a 256-slice computed tomography (CT) scanner? You can do all of those things in one second, but the one that may help save your life is the 256-slice CT scan.

"With one heartbeat, within one second, we can get an entire 3-D image of the heart that allows us to look at arteries and heart anatomy with excellent detail," explains Steven Mottl, D.O., medical director of non-invasive cardiology at The Heart Hospital Baylor Denton. That facility began using its 256-slice CT scanner in January; it is the first of its kind in Denton County and the third in the Dallas/Fort Worth area.

With that bird's eye imaging, cardiologists see the earliest signs of heart disease or existing heart disease not diagnosed with other testing modalities. Physicians can view the heart's anatomy, the pulmonary arteries and aorta and even the coronary arteries where atherosclerosis occurs.

"Patients and physicians are both frustrated that we have difficulty predicting a potential heart attack," explains Dr. Mottl. "With this type of study, it allows us to characterize the type of plaque a patient may have and use this information to predict whether a heart attack could occur. This allows us to select the patients that would benefit from more aggressive medications to lower their risk of having a heart attack, and eliminate the need for unnecessary additional testing in patients that are at low risk."

The 256-slice CT scanner takes only one second to scan the entire heart providing more information with each rotation - compared to four rotations with a 64-slice CT scanner, or 16 rotations with a 16-slice CT scanner. These older generation CT scanners take much longer to image the heart and require administration of medications to slow the heart rate to an accurate picture.

Another added benefit to the 256-slice scanner is that patients do not need to hold their breath during the scan. Many patients struggle to maintain an adequate breath hold, which results in un-interpretable images and possible need to repeat the scan. Some patients, especially children, sometimes require the use of sedation medications for imaging on older CT scanners.

While reducing heart disease with earlier diagnoses is one goal, reducing potential radiation exposure during the imaging procedure is equally important. Medical radiation for tests such as a CT scan are the cause for up to 50 percent of an individual's life time radiation exposure, and thought to be responsible for two percent of all cancers and much higher prevalence of cataracts, according to Dr. Mottl. The 256-slice CT scanner can give cardiologists a picture of the human heart with 60 percent less radiation exposure than older CT scan technology on average and in some patients greater than 90 percent reduction.

"With a 64-slice CT scan, the radiation exposure can be compared to having a few thousand chest X-rays. With the newer 256-slice CT technology, the radiation exposure would be equal to 100 chest X-rays," explains Dr. Mottl.

The new 256-slice CT scanner also offers diagnostic uses beyond diagnosing heart disease. "This scan allows us to look at vascular disease from the head to the foot," adds Steven Reiman, M.D., medical director of radiology at The Heart Hospital Baylor Denton. "The scanner's superior resolution allows us to more accurately look for disease in vessels like the renal arteries, carotid arteries, or arteries of the legs."