The good

Wilhelm Conrad Röntgen's detection of diagnostic radiation in 1895 has revolutionised medical diagnosis.1 Even today when cardiac imaging with sophisticated tools such as magnetic resonance and 3D echocardiography is available, plain chest roentgenograms retain a place in the daily routine as they show cardiac size and silhouette, large vessels, surrounding lung tissue and pulmonary vasculature. Moreover, fluoroscopy requires ionising radiation to guide catheters and instruments into the heart, thus enabling diagnostic and therapeutic interventions. Both, chest roentgenograms and fluoroscopy provide imaging with excellent spatial resolution but no true 3D information.

Much progress has been made since Röntgen's discovery, and image quality has been continuously improved. With the introduction of CT by Hounsfield in the 1970s, a true 3D modality became available for medical imaging. After further evolution of this technique, including spiral acquisition, ECG gating and multidetector technology, we can now reconstruct images in any desired cardiac phase and anatomical plane with submillimetre spatial resolution and excellent tissue contrast. The speed of the CT procedure has been increased to …