Calling all cards

Over the past three weeks, Philips Medical Systems has been talking up its vision for the future of cardiac CT. In five cities - Chicago, New York, Los Angeles, Dallas, and Ft. Lauderdale - on dates ranging from April 19 to May 5, Philips has presented the clinical benefits of diagnostic cardiovascular CT. Feature presentations were made by clinicians from Wisconsin Heart, Washington Hospital Center, the Healthcare Clinic of Arkansas, and Lake Cardiology.

While the venue changed, the audience did not. At each event, those invited to the free dinner meeting came from the rank and file of cardiology. The invitation list was in keeping with the goal of the meetings: to increase awareness of the value of multislice cardiovascular CT for private practice and hospital-based cardiology.

"The average cardiologist sees 165 new patients every month, so we understand the growing demand for new tools," said John Steidley, Philips Medical System's North American vice president for diagnostic imaging in a press advisory accompanying the announcement of the five-city tour.

Philips is far from being alone. Each of the major multislice vendors has created versions of 16-, 32, or 64-slice scanners specifically for use by cardiologists. These scanners may rotate faster. They may offer specialized software for cardiac or CV imaging. They may have simplified interfaces. Or they may have a little of each.

Promotions and pronouncements aimed at cardiologists may spark the ire of radiologists who for 30 years have had CT pretty much to themselves. But, really, vendors are more followers than leaders. Cardiologists' interest in this evolving application is booming. Just a few days ago, in Milwaukee, Wisconsin Heart, one of the presenters in Philips' road show, hosted a meeting of its own, entitled "Cardiac CT for the Cardiovascular Physician." Registration closed days before the meeting began, as organizers noted on their Web site a "tremendous" response.

Among the topics on the program was "discussion of future advocacy efforts for cardiologists interested in CT angiography." No big surprise here. Turf battles have raged for years over who will own and operate cardiovascular imaging equipment from gamma cameras to ultrasound. While the interest in CT is new, it shouldn't have been unexpected.

Equally unsurprising was a second topic of interest in the Wisconsin meeting: the option (sic) and handling of noncardiac structures. Clearly, cardiologists are neither trained nor particularly interested in assessing noncardiac structures. The need to address them is the point of possible collaboration between radiologists and cardiologists and an opportunity for both professions to work together. The chance that they will, however, is not looking very bright.

Advocacy groups who reach out only to their own groups do what comes naturally. The NRA is not going to invite advocates of gun control to their meetings any more than right to lifers are going to reach out to the advocates of choice. These groups don't have a common ground except what divides them. But cardiologists and radiologists do. They have the best interest of their patients.

Meetings and seminars can be the means for pulling these two professions together, or they can be the walls that keep them apart. As much as the future of cardiovascular CT angiography needs to be examined, so does the path for getting there.