Electron beam computed tomography no longer has a role to play in Germany. In contrast, multidetector spiral CT has great potential for replacing some coronary catheter studies, in particular for the exclusion of coronary artery disease, and this in particular since the forthcoming introduction of a 64-slice MDCT scanner promises a further improvement in temporal and special resolution. Currently, however it is no alternative to invasive angiography, since quantification of coronary stenoses is not possible; nor can a diagnostic evaluation be made in the presence of coronary calcifications or intracoronary stents. In particular, however, before applying CT angiography to the heart, the patient groups that can benefit from this method must be defined, especially in light of the fact that radiation exposure is three times as high as with diagnostic coronary catheterization.
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