Journal introduction

You have all heard the ads, “Buy gold now!” “You need gold in your portfolio?” But, the price of gold is up, and then it is down. And so goes the “gold standard.” In cardiovascular medicine, new technologies require foundational techniques as “gold standards” for comparison. But who defines what is and what is not “gold”? CT continues to challenge our notions of current gold standard techniques, and, in this issue, the strength and limitations of gold standard comparators for cardiovascular CT become even more apparent. Here, are a few examples. CT accurately detects features of arrhythmogenic right ventricular dysplasia, but the present techniques have their own limitations, and in some respects CT may be superior. CT dosimetry in pediatrics may be better modeled through size-specific dose estimations, rather than the traditional CT dose index. Diabetes represents a clinical cardiovascular risk equivalent diagnosis, but CT shows us not all persons with diabetes are alike for subclinical atherosclerosis. CT provides highly accurate left ventricular size assessments and measurements of the aortic annulus, pointing out the limitations of old techniques. CT angiography provides a highly accurate method of plaque burden, rivaling that of invasive intravascular ultrasound. So, the teaching point is to be fluid in our understanding and application of medical gold standards. CT continues to teach us that today’s gold may well be tomorrow’s bronze!