Reality and possibilities in cardiology imaging

Reality and possibilities in cardiology imaging

March 17, 2020
From the March 2020 issue of HealthCare Business News magazine

Cardiac CT
Overall, quote analysis requests to TractManager declined by 15% in the past 12 months compared to the prior year. There appear to be some developing trends toward a dedicated cardiac CT scanner, with several vendors recently introducing products for that market niche. The overall CT market is still reflective of a multi-functional CT scanner with advanced cardiac software as part of the package. We have seen about 23% of the quotes for CT incorporating advanced cardiac software, and about 17% of the upgrades were either for or included advanced cardiac applications.

Fractional Flow Reserve — Computed Tomography (FFR-CT) is a growing area of interest. FFR-CT provides the ability to noninvasively evaluate the possible physiological impact of coronary artery disease. This may shift the paradigm for interventional X-ray further away from diagnostic to more of an interventional approach. The ability to not just suggest the presence of disease, but also to predict that disease has or will soon have a negative clinical impact on the patient’s risk of a cardiovascular event may drive further use of advanced Cardiac CT.

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Cardiac MR
Although we saw about a 19% decline in quotes sent to TractManager for purchase consideration in 2019, we have seen a clear reflection of growing interest in the advance cardiac capabilities of MR. There is no clear delineation of 1.5T versus 3.0T systems, which seems to vary based on the vendor. Overall about 25% of new system quotes seen include advanced cardiac capabilities, with 14% of upgrades including advanced cardiac options.

The lack of radiation and ability to evaluate soft tissue and cardiac flow are key drivers behind the interest in cardiac MR. This solution begins to provide insight into cardiac function, blood flow, and motion. It offers the potential to begin to help formulate appropriate clinical responses for congestive heart failure (CHF) patients with decreased cardiac function. This is different from prior cardiac injury versus present cardiac risk based on yet-to-be-addressed disease (ischemia). Possible areas of interest are combined stress testing (physical or pharmaceutical) evaluation of ischemic impact on motion and heart function.

Tom Watson
It is likely cardiac MR workflow will heavily impact the concurrent evolution in AI. This may allow a workflow much more driven by large data analytics processing, reducing exam to conclusion time. It may also provide a more empiric, less judgment-based result. As the use of AI increases, it may provide a clearer path to the holy grail of healthcare, evidence-based medicine, driving proven clinical outcomes for patients.

About the author: Tom Watson, BS, RCVT, RDMS is senior clinical advisor/expert at TractManager. He has worked at MD Buyline for 30+ years. MD Buyline is now a part of the rebranded TractManager Inc.
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