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Review
. 2025 Jun;315(3):e240085.
doi: 10.1148/radiol.240085.

Future Applications of Cardiothoracic CT

Mark L Schiebler  1 , Masahiro Jinzaki  2 , Masahiro Yanagawa  3 , Amir Pourmorteza  4 , Yoshitake Yamada  2 , Yoko Kato  5 , Noriaki Wada  6 , Cornelia Schaefer-Prokop  7 , Vincent Dousset  8 , Noriyuki Tomiyama  9 , Mathias Prokop  7 , João A Lima  5 , Hiroto Hatabu  10
Affiliations
Review

Future Applications of Cardiothoracic CT

Mark L Schiebler et al. Radiology. 2025 Jun.

Abstract

Radiologists are witnessing astonishing innovation and advancement of CT technologies and their clinical applications. This review highlights how photon-counting CT (PCCT), upright CT, and artificial intelligence (AI) may impact cardiothoracic CT applications for imaging and diagnosis. PCCT relies on new detectors that can bin the separate photon energies and allow for lower radiation dose and better spatial resolution. The clinical applications of PCCT in the coronary arteries are becoming the new standard for cardiac CT imaging. New upright CT has shown the benefits of imaging in the upright position and offers new insight into how the upright position affects biomechanics and physiology. Four-dimensional CT, which can be used to directly image perfusion, is challenging MRI and MR angiography for primacy in this area. The burgeoning role of AI and informatics is changing the way radiologists interpret and report many imaging examinations. The future is bright and promises lower radiation and intravenous contrast agent doses and higher spatial resolution, and will further incorporate deep learning to improve the effectiveness of CT.

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Conflict of interest statement

Disclosures of conflicts of interest: M.L.S. Grants or contracts from Sophia Genetics; patents planned, issued, or pending (U.S. patents 7,164,360, 7,578,532, 7,582,089, 8,049,6295; Wisconsin Alumni Research Foundation patents P170195, P160386US01; international patent WO2017/197360 A1); shareholder in Stemina Biomarker Discovery, Elucida Oncology, and Elucent Medical; and senior consultant to the editor for Radiology. M.J. Grants or contracts to institution from Canon Medical Systems; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Canon Medical Systems; institutional patents planned, issued, or pending with Canon Medical Systems; and receipt of equipment, materials, drugs, medical writing, gifts or other services from Canon Medical Systems. M.Y. Associate editor for Radiology: Artificial Intelligence and associate editor for Japanese Journal of Radiology. A.P. Sponsored research agreements between institution and GE HealthCare, Canon Medical Research USA, and Siemens Healthineers; royalties from CardioWise; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from GE HealthCare; U.S. patents issued (10448901, US10959618B2); member of the GE HealthCare Physics Advisory Board; and chairman of the Medical Advisory Board for CardioWise. Y.Y. No relevant relationships. Y.K. Speaker fee from Canon Medical Systems. N.W. No relevant relationships. C.S.P. Royalties or licenses from Thieme, Elsevier, and Springer; consulting fees from Siemens and Philips; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Boehringer Ingelheim and Canon; support for attending meetings and/or travel from Canon; and associate editor for Radiology. V.D. No relevant relationships. N.T. No relevant relationships. M.P. Grants or contracts to institution from the Koningin Wilhelmina Fonds, Dutch government, and European Commission; royalties or licenses to institution from Canon Medical Systems; payments to institution for speakers bureaus from Siemens Healthineers, Canon Medical Systems, and Bracco; U.S. patents planned, issued, or pending (10,902,562 B2, 12,086,979 B2); vice-chairman of an advisory board for Kuratorium; second vice-president for the European Society of Radiology (since 2024); chairman of the Dutch Society of Radiology (until 2023); and receipt of equipment, materials, drugs, medical writing, gifts or other services (Prototype phto). J.A.L. Grant from Canon Medical Imaging and associate editor for Radiology. H.H. Grants to institution from Canon Medical Systems and Konica-Minolta; consulting fees from Canon Medical Systems, Boehringer Ingelheim, Boehringer Ingelheim Taiwan, and UpToDate; and provisional U.S. patent (63/610,842).

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