Emerging imaging techniques after cardiac transplantation

Improvements in survival after cardiac transplantation have in part been driven by improved graft surveillance. Graft surveillance relies mainly on 3 techniques: coronary angiography, endomyocardial biopsy and echocardiography. Developments in invasive and non-invasive imaging technology have revolutionized assessment of the heart in both health and disease, offering new insights into tissue composition and myocardial metabolism. Herein we aim to review the strengths and weaknesses of these techniques, and summarize the evidence in the following 5 fields of cardiac imaging after transplantation: cardiovascular magnetic resonance; computed tomography; positron emission tomography; single-photon emission computed tomography; and optical coherence tomography and molecular imaging techniques.