Current and Emerging Technologies for Cardiovascular Imaging

  • Erik Hedström
  • Ellen Ostenfeld
  • Marcus Carlsson
  • Per M. Arvidsson
  • Christos G. Xanthis
  • Kostas Haris
  • Einar Heiberg
  • Anthony H. AletrasEmail author
Part of the Series in BioEngineering book series (SERBIOENG)


Cardiovascular disease is the leading cause of death in the western world. With the application of theoretical physics to the clinic, a variety of imaging technologies are available to the physician for diagnosing and accurately quantifying disease progression. These tools can influence how therapies are applied and impact patient outcome. Radiographic methods based on x-rays are used for diagnosis (Computed Tomography) and therapy (catheterization suite). Nuclear medicine with Single Photon Emission Tomography (SPECT) and Positron Emission Tomography (PET) are routinely used for detecting irreversible and reversible ischemic injury. Ultrasound echocardiography is also routinely used for visualizing contractile function and quantifying blood velocities. Cardiac Magnetic Resonant Imaging allows for a one-stop-shop evaluation of the cardiovascular system including function, tissue perfusion and viability and well as edema visualization, extracellular volume imaging, iron overload, etc. The emergence of new technologies for acquiring data with existing techniques, such as sparse undersampling, and radically new approaches, such as Optical Coherence Tomography and Near Infrared Spectroscopy, open uncharted domains and promise even better diagnostics in the future.


  1. 1.
    Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, Ferreira JR, Gersh BJ, Gitt AK, Hulot JS, Marx N, Opie LH, Pfisterer M, Prescott E, Ruschitzka F, Sabaté M, Senior R, Taggart DP, van der Wall EE, Vrints CJ; ESC Committee for Practice Guidelines, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Document Reviewers, Knuuti J, Valgimigli M, Bueno H, Claeys MJ, Donner-Banzhoff N, Erol C, Frank H, Funck-Brentano C, Gaemperli O, Gonzalez-Juanatey JR, Hamilos M, Hasdai D, Husted S, James SK, Kervinen K, Kolh P, Kristensen SD, Lancellotti P, Maggioni AP, Piepoli MF, Pries AR, Romeo F, Rydén L, Simoons ML, Sirnes PA, Steg PG, Timmis A, Wijns W, Windecker S, Yildirir A, Zamorano JL (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34(38):2949–3003Google Scholar
  2. 2.
    Rybicki FJ, Udelson JE, Peacock WF, Goldhaber SZ, Isselbacher EM, Kazerooni E, Kontos MC, Litt H, Woodard PK (2016) 2015 ACR/ACC/AHA/AATS/ACEP/ASNC/NASCI/SAEM/SCCT/SCMR/SCPC/SNMMI/STR/STS appropriate utilization of Cardiovascular imaging in emergency department Patients with Chest Pain: a joint document of the American College of Radiology Appropriateness Criteria Committee and the American College of Cardiology Appropriate Use Criteria Task Force. JACR 13(2):e1–e29Google Scholar
  3. 3.
    Baptista SB, Raposo L, Santos L, Ramos R, Calé R, Jorge E, Machado C, Costa M, Infante de Oliveira E, Costa J, Pipa J, Fonseca N, Guardado J, Silva B, Sousa MJ, Silva JC, Rodrigues A, Seca L, Fernandes R (2016) Impact of routine fractional flow reserve evaluation during coronary angiography on management strategy and clinical outcome: one-year results of the POST-IT, Circ Cardiovasc Interv 9(7):pii: e003288Google Scholar
  4. 4.
    Götberg M, Christiansen EH, Gudmundsdottir IJ, Sandhall L, Danielewicz M, Jakobsen L, Olsson SE, Öhagen P, Olsson H, Omerovic E, Calais F, Lindroos P, Maeng M, Tödt T, Venetsanos D, James SK, Kåregren A, Nilsson M, Carlsson J, Hauer D, Jensen J, Karlsson AC, Panayi G, Erlinge D, Fröbert O (2017) Instantaneous wave-free ratio versus fractional flow reserve to guide PCI. N Engl J Med 376(19):1813–1823CrossRefGoogle Scholar
  5. 5.
    Cury RC,Abbara S, Achenbach S, Agatston A, Berman DS, Budoff MJ, Dill KE, Jacobs JE, Maroules CD, Rubin GD, Rybicki FJ, Schoepf UJ, Shaw LJ, Stillman AE, White CS, Woodard PK, Leipsic JA (2016) CAD-RADS(TM) Coronary Artery Disease—Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology. J Cardiovasc Comput Tomogr 10(4):269–281CrossRefGoogle Scholar
  6. 6.
    Wolk MJ, Bailey SR, Doherty JU, Douglas PS, Hendel RC, Kramer CM, Min JK, Patel MR, Rosenbaum L, Shaw LJ, Stainback RF, Allen JM; Technical Panel, Brindis RG, Kramer CM, Shaw LJ, Cerqueira MD, Chen J, Dean LS, Fazel R, Hundley WG, Itchhaporia D, Kligfield P, Lockwood R, Marine JE, McCully RB, Messer JV, O’Gara PT, Shemin RJ, Wann LS, Wong JB; Appropriate Use Criteria Task Force, Patel MR, Kramer CM, Bailey SR, Brown AS, Doherty JU, Douglas PS, Hendel RC, Lindsay BD, Min JK, Shaw LJ, Stainback RF, Wann LS, Wolk MJ, Allen JM (2014) ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Card Fail 20(2):65–90 (Multimodality Writing Group for Stable Ischemic Heart Disease)Google Scholar
  7. 7.
    Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, Rubin GD (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation appropriate use criteria task force, the society of cardiovascular computed tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Cardiovasc Comput Tomogr 4(6):407.e1-33Google Scholar
  8. 8.
    Halliburton SS, Abbara S, Chen MY, Gentry R, Mahesh M, Raff GL, Shaw LJ, Hausleiter J (2011) SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 5(4):198–224CrossRefGoogle Scholar
  9. 9.
    Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ (2014) ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 35(41):2873–926Google Scholar
  10. 10.
    Chen MY, Rochitte CE, Arbab-Zadeh A, Dewey M, George RT, Miller JM, Niinuma H, Yoshioka K, Kitagawa K, Sakuma H, Laham R, Vavere AL, Cerci RJ, Mehra VC, Nomura C, Kofoed KF, Jinzaki M, Kuribayashi S, Scholte AJ, Laule M, Tan SY, Hoe J, Paul N, Rybicki FJ, Brinker JA, Arai AE, Matheson MB, Cox C, Clouse ME, Di Carli MF, João AC (2017) Prognostic value of combined CT angiography and myocardial perfusion imaging versus invasive Coronary Angiography and nuclear stress perfusion imaging in the prediction of major adverse cardiovascular events: the CORE320 multicenter Study. Radiology 284(1):55–65CrossRefGoogle Scholar
  11. 11.
    Douglas PS, Pontone G, Hlatky MA, Patel MR, Norgaard BL, Byrne RA, Curzen N, Purcell I, Gutberlet M, Rioufol G, Hink U, Schuchlenz HW, Feuchtner G, Gilard M, Andreini D, Jensen JM, Hadamitzky M, Chiswell K, Cyr D, Wilk A, Wang F, Rogers C, De Bruyne B, Clinical outcomes of fractional flow reserve by computed tomographic angiography-guided diagnostic strategies vs. usual Verberne HJ1, Acampa W2, Anagnostopoulos C3, Ballinger J4, Bengel F5, De Bondt P6, Buechel RR7, Cuocolo A8, van Eck-Smit BL9, Flotats A10, Hacker M11, Hindorf C12, Kaufmann PA7, Lindner O13, Ljungberg M14, Lonsdale M15, Manrique A16, Minarik D17, Scholte AJ18, Slart RH19, Trägårdh E20, de Wit TC9, Hesse B care in patients with suspected coronary artery disease: the prospective longitudinal trial of FFR(CT): outcome and resource impacts study. Eur Heart J 36(47):3359–3367Google Scholar
  12. 12.
    Verberne HJ, Acampa W, Anagnostopoulos C, Ballinger J, Bengel F, De Bondt P, Buechel RR, Cuocolo A, van Eck-Smit BL, Flotats A, Hacker M, Hindorf C, Kaufmann PA, Lindner O, Ljungberg M, Lonsdale M, Manrique A, Minarik D, Scholte AJ, Slart RH, Trägårdh E, de Wit TC, Hesse B (2015) EANM procedural guidelines for radionuclide myocardial perfusion imaging with SPECT and SPECT/CT: 2015 revision. Eur J Nucl Med Mol Imaging 42(12):1929–1940CrossRefGoogle Scholar
  13. 13.
    Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16(3):233–270CrossRefGoogle Scholar
  14. 14.
    Lancellotti P, Tribouilloy C, Hagendorff A, Popescu BA, Edvardsen T, Pierard LA, Badano L, Zamorano JL (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14(7):611–644CrossRefGoogle Scholar
  15. 15.
    Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713, quiz 786–788CrossRefGoogle Scholar
  16. 16.
    Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, Dulgheru R, El Khoury G, Erba PA, Iung B, Miro JM, Mulder BJ, Plonska-Gosciniak E, Price S, Roos-Hesselink J, Snygg-Martin U, Thuny F, Tornos Mas P, Vilacosta I, Zamorano JL (2015) 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 36(44):3075–3128CrossRefGoogle Scholar
  17. 17.
    Haugaa KH, Basso C, Badano LP, Bucciarelli-Ducci C, Cardim N, Gaemperli O, Galderisi M, Habib G, Knuuti J, Lancellotti P, McKenna W, Neglia D, Popescu BA, Edvardsen T (2017) Comprehensive multi-modality imaging approach in arrhythmogenic cardiomyopathy-an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 18(3):237–253CrossRefGoogle Scholar
  18. 18.
    Cardim N, Galderisi M, Edvardsen T, Plein S, Popescu BA, D’Andrea A, Bruder O, Cosyns B, Davin L, Donal E, Freitas A, Habib G, Kitsiou A, Petersen SE, Schroeder S, Lancellotti P, Camici P, Dulgheru R, Hagendorff A, Lombardi M, Muraru D, Sicari R (2015) Role of multimodality cardiac imaging in the management of patients with hypertrophic cardiomyopathy: an expert consensus of the European Association of Cardiovascular Imaging Endorsed by the Saudi Heart Association. Eur Heart J Cardiovasc Imaging 16(3):280CrossRefGoogle Scholar
  19. 19.
    Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37(1):67–119CrossRefGoogle Scholar
  20. 20.
    Erbel R, Aboyans V, Boileau C, Bossone E, Di Bartolomeo R, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwoger M, Haverich A, Iung B, John Manolis A, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, von Allmen RS, Vrints CJ (2015) Corrigendum to: 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases. Eur Heart J 36(41):2779CrossRefGoogle Scholar
  21. 21.
    Lanzer P, Botvinick EH, Schiller NB, Crooks LE, Arakawa M, Kaufman L et al (1984) Cardiac imaging using gated magnetic resonance. Radiology 1(150):121–127CrossRefGoogle Scholar
  22. 22.
    Ordidge RJ, Mansfield P, Doyle M, Coupland RE (1982) Real time movie images by NMR. Br J Radiol 55(658)CrossRefGoogle Scholar
  23. 23.
    Oppelt A, Graumann R, Barfuss H, Fischer H, Hartl W, Schajor W (1986) FISP—a new fast MRI sequence. Electromedica 54:15–18Google Scholar
  24. 24.
    Moran PR (1982) A flow velocity zeugmatographic interlace for NMR imaging in humans. Magn Reson Imaging 1:197–203CrossRefGoogle Scholar
  25. 25.
    Hofman MB, Visser FC, van Rossum AC, Vink GQM, Sprenger M, Westerhof N (1995) In: vivo validation of MRI blood volume flow measurements with limited spatial resolution in small vessels.pdf. Magn Reson Med 33:778–84Google Scholar
  26. 26.
    Kim RJ, Fieno DS, Parrish TB, Harris K, Chen E, Simonetti O et al (1999) Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation 100(19):1992–2003CrossRefGoogle Scholar
  27. 27.
    Sörensson P, Heiberg E, Saleh N, Bouvier F, Caidahl K, Tornvall P et al (2010) Assessment of myocardium at risk with contrast enhanced steady-state free precession cine cardiovascular magnetic resonance compared to single-photon emission computed tomography. J Cardiovasc Magn Reson 12(1):25CrossRefGoogle Scholar
  28. 28.
    Messroghli DR, Radjenovic A, Kozerke S, Higgins DM, Sivananthan MU, Ridgway JP (2004) Modified look-locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med 146:141–146CrossRefGoogle Scholar
  29. 29.
    Arheden H, Saeed M, Higgins CB, Gao DW, Bremerich J, Wyttenbach R et al (1999) Measurement of the distribution volume of gadopentetate dimeglumine at echo-planar MR imaging to quantify myocardial infarction: comparison with 99mTc-DTPA autoradiography in rats. Radiology 3(211):698–708CrossRefGoogle Scholar
  30. 30.
    Kellman P, Aletras AH, Mancini C, McVeigh ER, Arai AE (2007) T2-prepared SSFP improves diagnostic confidence in edema imaging in acute myocardial infarction compared to Turbo Spin Echo. Magn Reson Med 57(5):891–897CrossRefGoogle Scholar
  31. 31.
    Anderson LJ, Holden S, Davis B, Prescott E, Charrier CC, Bunce NH et al (2001) Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 22:2171–2179CrossRefGoogle Scholar
  32. 32.
    Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P (1999) SENSE: sensitivity encoding for fast MRI. Magn Reson Med 42(5):952–962CrossRefGoogle Scholar
  33. 33.
    Griswold MA, Jakob PM, Heidemann RM, Nittka M, Jellus V, Wang J, Kiefer B, Haase A (2002) Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 47(6):1202–1210CrossRefGoogle Scholar
  34. 34.
    Candes EJ, Romberg J, Tao T (2006) Robust uncertainty principles: exact signal reconstruction from highly incomplete frequency information. IEEE Trans Inf Theory 52(2):489–509MathSciNetCrossRefGoogle Scholar
  35. 35.
    Donoho DL (2006) Compressed sensing. IEEE Trans Inf Theory 52(4):1289–1306MathSciNetCrossRefGoogle Scholar
  36. 36.
    Lustig M, Donoho D, Pauly JM (2007) Sparse MRI: the application of compressed sensing for rapid MR imaging. Magn Reson Med 58(6):1182–1195CrossRefGoogle Scholar
  37. 37.
    Ravishankar S, Bresler Y (2011) MR image reconstruction from highly undersampled k-space data by dictionary learning. IEEE Trans Med Imaging 30(5):1028–1041CrossRefGoogle Scholar
  38. 38.
    Wang Y, Ying L (2014) Compressed sensing dynamic cardiac cine MRI using learned spatiotemporal dictionary. IEEE Trans Biomed Eng 61(4):1109–1120CrossRefGoogle Scholar
  39. 39.
    Block KT, Uecker M, Frahm J (2007) Undersampled radial MRI with multiple coils. Iterative image reconstruction using a total variation constraint. Magn Reson Med 57(6):1086–1098CrossRefGoogle Scholar
  40. 40.
    Tropp JA, Wright SJ (2010) Computational methods for sparse solution of linear inverse problems. Proc IEEE 98(6):948–958CrossRefGoogle Scholar
  41. 41.
    Hoang V, Grounds J, Pham D, Virani S, Hamzeh I, Qureshi AM, Lakkis N, Alam M (2016) The role of intracoronary plaque imaging with intravascular ultrasound optical coherence tomography, and near-infrared spectroscopy in patients with coronary artery disease. Curr Atheroscler Rep 18(9):57CrossRefGoogle Scholar
  42. 42.
    Schoenhagen P, Nissen S (2002) Understanding coronary artery disease: tomographic imaging with intravascular ultrasound. Heart 88(1):91–96CrossRefGoogle Scholar
  43. 43.
    Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA et al (1991) Opt Coherence Tomogr. Science 254(5035):1178–1181CrossRefGoogle Scholar
  44. 44.
    Gardner CM, Tan H, Hull EL, Lisauskas JB, Sum ST, Meese TM, Jiang C, Madden SP, Caplan JD, Burke AP, Virmani R, Goldstein J, Muller JE (2008) Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system. JACC Cardiovasc Imaging 1(5):638–648CrossRefGoogle Scholar
  45. 45.
    Evertsson M, Cinthio M, Fredriksson S, Olsson F, Persson H, Jansson T (2013) Frequency- and phase-sensitive magnetomotive ultrasound imaging of superparamagnetic iron oxide nanoparticles. IEEE Trans Ultrason Ferroelectr Freq Control 60(3):481–491CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Erik Hedström
    • 1
  • Ellen Ostenfeld
    • 1
  • Marcus Carlsson
    • 1
  • Per M. Arvidsson
    • 1
  • Christos G. Xanthis
    • 1
    • 2
  • Kostas Haris
    • 1
    • 2
  • Einar Heiberg
    • 1
  • Anthony H. Aletras
    • 1
    • 2
    Email author
  1. 1.Faculty of Clinical Sciences, Department of Clinical Physiology and Nuclear MedicineLund University and Skåne University HospitalLundSweden
  2. 2.Laboratory of Computing, Medical Informatics and Biomedical – Imaging Technologies, Faculty of Health Sciences, School of MedicineAristotle University of ThessalonikiThessalonikiGreece

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