Most influential advances in cardiopulmonary imaging: High-resolution CT and CT pulmonary angiography

Advances in computed tomography (CT) providing high-resolution images of the lungs and a new approach to diagnosis of pulmonary embolism (PE) are "the most influential" changes in cardiopulmonary imaging over the past 25 years, according to a panel of experts surveyed in the February Journal of Thoracic Imaging ( official journal of the Society of Thoracic Radiology and the Japanese and Korean Societies of Thoracic Radiology. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

To mark the 25th anniversary of the Journal of Thoracic Imaging, the editors asked 25 international leaders in cardiopulmonary imaging, "What is the most influential article or advance in our specialty in the past 25 years?" "High-resolution CT and CT pulmonary angiography were the leading specialty-specific responses," says Phillip M. Boiselle, M.D., Editor-in-Chief of JTI.

Once-Revolutionary Techniques Are Now Part of Routine Cardiopulmonary Imaging High-resolution CT—a technique providing much more highly detailed images of the lungs than conventional CT—was cited as the most important advance in pulmonary imaging. "[H]igh-resolution chest CT...has permitted a much greater understanding of interstitial lung disease," says contributor Theresa McLoud, M.D. "It has increased the accuracy of diagnosis, and the ability of the radiologist to understand the anatomic distribution of disease at the lobular level, to provide a quantitative analysis of the severity of disease and to assess response to treatment."

The experts rated CT pulmonary angiography—which has greatly enhanced the challenging diagnosis of PE—as the most influential new advance in cardiopulmonary imaging. A seminal 1992 study by Martine Remy-Jardin, M.D., Ph.D., comparing spiral CT angiography to conventional angiography for diagnosis of PE was cited as the single most influential article of the past 25 years. "A truly disruptive technique in radiology completely changes the way a disease is diagnosed," comments Lawrence R. Goodman, M.D. "This paper totally changed the diagnostic approach to PE and in addition has provided new clinical insights into a perplexing disease."

When the first issue of JTI appeared in 1985, high-resolution CT was a revolutionary new approach on the cutting edge of radiology and CT pulmonary angiography was hardly imaginable, Dr. Boiselle points out. These same technologies now comprise the mainstay of thoracic imaging. Other advances cited by the experts include multidetector-row CT technology, CT coronary angiography, and cardiac MRI.

The article, the first of a special "25 on 25" series, is also freely available online at the JTI website, The journal website also features a "quick poll" in which readers can give their opinions on the most important advances, as well as access to other special 25th anniversary features. The "25 on 25" series will continue throughout 2010, as the experts share their views on which advances failed to live up to expectations, the greatest opportunities and challenges facing cardiopulmonary imaging, and what the specialty will look like in 2035.


Journal of Thoracic Imaging


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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