Dave Fornell, ITN Editor

Dave Fornell is the editor of Diagnostic & Interventional Cardiology magazine and assistant editor for Imaging Technology News magazine.

Blog | Dave Fornell, ITN Editor | August 29, 2012

Which Cardiac Imaging Modality Will Become The One-Stop Shop?

Cardiac computed tomography (CT)magnetic resonance imaging (MRI)echocardiography and nuclear myocardial perfusion imaging each offer advantages and disadvantages, and frequently at least two of these tests are required to get the full picture of a patient’s cardiac health.  However, in this age of cutting healthcare costs, declining reimbursements and improving efficiency, it would be advantageous to have a single gold standard exam. Technology advances are now making that possibility. 

MRI is ideal because it uses zero radiation, offers higher contrast and clarity than CT, can image without contrast and performs perfusion exams. But, its limitation remains its expense, ferrous metal and implantable device safety issues and the complexity of its operation. 

Nuclear imaging is limited because it fails to provide detailed anatomical information and uses ionizing radiation. It also is expensive, and short half-life radiotracers limit its hours of operations and on-demand use.

Software advances have improved 3-D echo image quality to the point where it appears like a CT reconstruction. It uses no radiation and offers immediate images of anatomy inside the body. But, echo has a limited ability to image the function of the heart. It also requires highly trained operators to ensure precise positioning of the transducer and interpretation can be subjective. (To read about recent echo advances from the September-October 2012 issue, go to www.dicardiology.com/article/ultrasound-sees-increasing-use-interventional-procedures)

CT has the major disadvantage of high radiation doses compared to other modalities, but technical advances make CT the most likely dominant cardiac imaging technology in the next decade.  The rapid expansion and decreasing cost of computing power has enabled fast iterative reconstruction software for lower dose scans. New detector technology is reducing the amount of electronic noise in lower-dose scans and new ECG gating technology has helped cut dose. Combined, these advances have reduced CT dose by more than 50 percent compared to doses a few years ago. 

CT analysis software now allows visualization and quantification of perfusion in the myocardium with images similar to nuclear studies, but with a highly accurate anatomic image base.  

Taking perfusion imaging a step further, CT software now cleared in Europe and in trials in the United States can quantify the fractional flow reserve (FFR) for all vessel segments in the coronary tree, allowing cardiologists to pinpoint the exact lesion causing ischemia. In the future, this technology may eliminate the need for diagnostic catheter angiography and provide a detailed navigation and treatment plan for interventional cardiologists to cut procedure time and improve patient outcomes.  (To read more about these CT advances in the September-Octover 2012 issue, go to www.dicardiology.com/article/latest-advances-coronary-ct-angiography-software.)

Lastly, CT is already a primary tool in emergency rooms and radiology departments across the country. Its widespread availability, ease of use and elimination of user-dependent variability makes CT a primary candidate. 

Related Content

Technology | Focused Ultrasound Therapy | June 19, 2018
EDAP TMS SA has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Focal One device for...
Epsilon Imaging Demonstrates Strain Imaging Integration for Echo Programs at ASE 2018
News | Cardiovascular Ultrasound | June 19, 2018
Clinical practice, along with guidelines and research, have shown that speckle tracking strain imaging can improve...
FDA Clears Bay Labs' EchoMD AutoEF Software for AI Echo Analysis
Technology | Cardiovascular Ultrasound | June 19, 2018
Cardiovascular imaging artificial intelligence (AI) company Bay Labs announced its EchoMD AutoEF software received 510(...
Report Finds Identifying Patients for Lung Cancer Screening Not So Simple
News | Lung Cancer | June 18, 2018
New findings in the current issue of The American Journal of Managed Care suggest that getting the right patients to...
Weight-Bearing CT International Study Group Hosts  Scientific Session at AOFAS Conference
News | Computed Tomography (CT) | June 15, 2018
June 15, 2018 —The Weight-Bearing CT International Study Group will host a scientific session on the benefits of weig
Florida Hospital First in State to Adopt NeuroLogica's BodyTom Elite CT
News | Computed Tomography (CT) | June 14, 2018
June 14, 2018 — NeuroLogica, a subsidiary of Samsung Electronics Co.
Hitachi Medical Systems Europe Named Imaging Supplier for London Prostate Cancer Program
News | Prostate Cancer | June 14, 2018
Hitachi Medical Systems Europe has been awarded the contract to supply six ultrasound systems as part of the RAPID...
Riverain Technologies Issued U.S. Patent for Vessel Suppression Technology
News | Computed Tomography (CT) | June 14, 2018
Riverain Technologies announced that the United States Patent and Trademark Office (USPTO) has awarded the company a...
360 Photos | 360 View Photos | June 14, 2018
This is a 360 degree image from the Canon Aquilion 64-slice...
American Society of Neuroradiology Honors Peter Chang with Cornelius G. Dyke Memorial Award
News | Neuro Imaging | June 13, 2018
Peter Chang, M.D., current neuroradiology fellow at UCSF and recently recruited co-director of the UCI Center for...
Overlay Init