Cardiac MRI

The RSNA is without doubt the big Kahuna of radiology medical meetings. With 60,000+ attendees and a program book that spans nearly 1000 pages in small type, the fall RSNA meeting sets the agenda for much of what goes on in radiology.

Recent advancements in electrocardiogram recording and encryption allow digital storage and secure e-mail transmission, reducing report turnaround time by two to three weeks.

Bedside ultrasound can be a valuable diagnostic tool for monitoring pulmonary congestion in patients with acute decompensated heart failure. As the heart weakens, fluid backs up into the lungs, and critical patients could benefit greatly by being monitored for their condition without having to be moved for radiographs or other diagnostic tests.

With piles of accumulated evidence demonstrating the ability of multislice CT to diagnose coronary artery disease, researchers are expanding clinical application of the modality to the measurement of myocardial viability following infarction.

Excitement is never in short supply in Las Vegas. But a new session at the 2008 Stanford International Multidetector-Row CT Symposium may give the casinos, cocktail lounges, and Canadian circus acts a run for their money.

Most interpreters of cardiac SPECT use any of three software packages provided by vendors of gamma cameras and PACS: the Quantitative Gated SPECT algorithm from the Cedars-Sinai Medical Center, Emory Cardiac Tool Box from Emory University Hospital, or 4D-MSPECT from the University of Michigan Medical Center.

Preoperative cardiac stress tests in hip fracture patients lead to unnecessary surgical delays and prolonged hospital stays, according to Mayo Clinic researchers.

Medicare's decision against a national coverage determination for coronary CT angiography is not the end of conflict for the modality. It is just the beginning. The next battle involves fulfilling the promises the multisociety alliance made to assure the Centers for Medicare and Medicaid Services that its acceptance of coronary CT will not turn into a multibillion-dollar debacle.

A preliminary study indicates that first-pass and delayed-enhancement myocardial CT correlate well with measures of infarction size gathered with equivalent cardiac MR procedures.

Calcium deposits in coronary arteries provide a strong predictor for incidence of heart attack and cardiac disease, and detecting such deposits via CT scanning can help promote overall cardiac health in racially and ethnically diverse populations, according to a new study in March 28 issue of The New England Journal of Medicine.

Medicare’s decision against a national coverage determination for cardiac CT is not the end of conflict for the modality. It is just the beginning.

Traditional reliance on physical symptoms leads to surgery after heart has already been damaged

Cardiac CT supporters are crediting a multisociety lobbying effort and solid scientific evidence for the Centers for Medicare and Medicaid Services decision Wednesday to not move forward with a national coverage policy for coronary CT angiography.

The enhanced spatial resolution and speed afforded by 64-slice CT scanning could enable the accurate assessment of right ventricular function in patients with cardiovascular disease, according to researchers in China and the U.S.

The enhanced spatial resolution and speed afforded by 64-slice CT scanning could enable the accurate assessment of right ventricular function in patients with cardiovascular disease, according to researchers in China and the U.S.

Cardiac imaging is at a crossroads, according to next year’s ECR president. He’s not alone in holding such an opinion.

Patients’ risk of developing a radiation-induced cancer is actually far lower than reports suggest, ECR delegates concerned about the level of radiation associated with cardiac CT were told in Vienna.

Restrictions on coronary CT angiographypayments respond to self referral, utilization

Cardiac MR codes grant a victory despite continued Medicare ban on blood flow measurement payment

Dual-source or 64-slice CT examination proves quick, noninvasive, and effective in triaging patients with low to moderate risk of heart disease

CMS stirs up hornet’s nest with threat to disallowan option for local Medicare coverage decisions and prohibit cardiac CT angiography for all but trial patients

tudies of chest pain patients with conventional 64-slice and dual-source CT add to a growing base of evidence suggesting that CT is well suited to rule out acute coronary syndrome in the emergency room and to identify coronary artery in-stent restenosis. An initial study of 256-slice CT presented at the RSNA meeting was encouraging, but the specter of high radiation exposure—especially exams covering the entire chest—challenged researchers to find better ways to reduce dose.

The American Society of Echocardiography has issued a new consensus statement for interpreting and responding to results of carotid artery ultrasound. The guidelines set carotid artery wall thickness values greater than the 75th percentile as the threshold for aggressive treatment.

Cardiac CT boosts self-referred utilization, other nonradiology specialists see modest growth

Researchers stress need for better dose reduction strategies as whole-chest exams earn positive reviews

he explosive growth of Medicare outpatient imaging from 2000 to 2005 explains why federal regulators have singled out radiologists for restraints. Medicare payments for outpatient medical imaging jumped 93% during that period, from $6 billion to more than $11 billion.

Studies of chest pain patients with conventional 64-slice and dual-source CT add to a growing base of evidence suggesting that CT is well suited to rule out acute coronary syndrome in the emergency room and to identify coronary artery in-stent restenosis. An initial study of 256-slice CT presented at the RSNA meeting was encouraging, but the specter of high radiation exposure-especially exams covering the entire chest-challenged researchers to find better ways to reduce dose.

Investigators begin recruiting the first of 7300 volunteers this month for a massive clinical trial to determine if a combination of blood tests, body measurements, and imaging exam can outperform the Framingham tests for assessing older adults who carry an intermediate risk of a major cardiovascular event, including myocardial infarction and stroke.

Increasing efforts to screen and diagnose coronary artery disease have used imaging modalities such as catheter angiography, ultrasound, and MRI. Electron-beam CT was, for a long time, the only CT system able to image the coronary arteries without motion artifacts. But multislice CT has advanced rapidly over the last decade, and state-of-the-art 64-slice and dual-source CT now offer high-quality imaging of the coronary arteries, myocardium, and valves, providing morphological and even functional information.

In the October 2006 issue of Diagnostic Imaging, I wrote a brief article describing the benefits of using prospective gating when performing coronary CT angiography.