J Cardiovasc Comput Tomogr. 2014 Nov-Dec;8(6):414-7. doi: 10.1016/j.jcct.2014.09.008. Epub 2014 Sep 28.
Schmermund A.
Because of the increasingly widespread use of cardiac CT imaging, the Agatston calcium score has received great scientific and clinical interest. It was the first approach to quantifying coronary artery calcium. The Agatston score was created in 1990, and entering a respective search in “PubMed” yields 2620 scientific articles, with the number of published articles increasing year by year up to today.1 The score was named after Dr Arthur Agatston, who continues to practice cardiology in Miami Beach, Florida. The work leading to the Agatston calcium score was done at Mount Sinai Medical Center in Miami Beach in the late 1980s. The present article is based on an interview Dr Agatston gave the author on July 15, 2014. Also, the written recollection of Dr Warren Janowitz, Dr Agatston's main collaborator, is included. Dr Janowitz is nowadays practicing as a radiologist in Miami, Florida.
In the 1980s, the only CT scanner capable of providing for motion-free images of the heart was the electron-beam CT (EBCT) scanner. It had originally been devised by Douglas Boyd and others to help overcome the limitations of echocardiography. In the 1970s, at the time the EBCT technology was invented, echocardiography was still in its early days, and it was not always possible to clearly delineate left ventricular myocardial contours. As opposed to conventional CT scanners based on a rotating X-ray tube, EBCT had no mechanically moving parts. The electron beam which created the X-rays was steered electromagnetically to allow for, at the time, extremely short image acquisition times of only 50 to 100 ms per slice. Throughout the cardiac cycle, the myocardium could thus be visualized without major motion artifacts. Before, the heart had been a blank in CT studies, whereas it was now possible to obtain high-quality images that could be used for analyses of left ventricular geometry and function. Unfortunately, echocardiography was coming along fast, leaving no role for EBCT to show left ventricular contractile function. Nevertheless, there was quite some interest in this fascinating new machine.
Full Article: http://www.sciencedirect.com/science/article/pii/S1934592514002482