Can CT angiography replace catheter coronary angiography?

After a decade of rapid technological development cardiac CT has evolved into a valuable non-invasive coronary imaging technique, which raises the question whether this new diagnostic modality is ready to replace diagnostic catheter angiography. CT coronary angiography may not yet match the spatial and temporal resolution of selective X-ray angiography, it surpasses invasive angiography in terms of three-dimensional orientation, imaging of plaque and ostial abnormalities. For the moment invasive angiography combined with stress testing will remain the preferred approach in patients with a high probability of coronary disease and anticipated percutaneous intervention. However, for many patients with a low to intermediate likelihood of coronary artery disease, CT can be a reliably non-invasive alternative to catheter angiography.