Cardiac imaging is a fast-growing subspecialty of diagnostic radiology that plays a huge part in the assessment and management of heart patients throughout the world. Cardiac radiologists – the experts in charge – supervise or perform imaging examinations, using technology such as computed tomography (CT) and magnetic resonance imaging (MRI), and then interpret the resulting images to diagnose and monitor a wide range of diseases of the heart.
For IDoR 2018, we are highlighting the increasingly important role of radiologists in cardiac care, contributing to the diagnosis, pre-procedural work-up and follow-up of patients with a wide variety of cardiac pathology, from coronary artery disease and leaky heart valves to defects in the size and shape of the heart.
While cardiac imaging as a whole incorporates conventional angiography of the coronary arteries, echocardiography, and nuclear imaging studies, the contribution of radiologists lies primarily in the fast-evolving non-invasive imaging assessment of cardiac and coronary disease, helping clinicians to diagnose a wide variety of possible pathologies.
The most important imaging modalities in cardiac radiology are computed tomography (CT) and magnetic resonance imaging (MRI).
- Cardiac CT has gained an important place in the non-invasive evaluation of potential coronary artery disease, helping referring clinicians to rule out significant coronary artery disease, for example, in patients with non-specific symptoms, and other inconclusive examinations. It also plays a prominent role in the pre-procedural assessment of novel transcatheter aortic and mitral valve replacement procedures.
- Cardiac MRI is mostly used to focus on cardiac morphology and tissue characterisation, helping in the detection and characterisation of cardiomyopathies, congenital heart disease, different types of scar tissue, and in the evaluation of valvular heart disease.
Studies and Statistics
Studies from the United States suggest that cardiac images account for up to one third of the billions of radiological studies performed worldwide each year1, 2. The continuing expansion of cardiac imaging is made possible by rapid technological advances and the increased specialisation of radiology professionals in recent years and decades, and has made medical imaging an essential tool in providing healthcare to patients with cardiovascular diseases.
The European Society of Cardiovascular Radiology’s European MR/CT Registry3 provides insights into the enormous volume of cardiac imaging examinations and the wide range of applicable clinical indications, demonstrating how radiology helps treat countless patients and save thousands of lives every year. As cardiac diseases are among the most prevalent in the world – cardiovascular disease is the leading cause of death worldwide according to the World Health Organization4 – it is all the more important for patients that radiology provides effective tools to reduce the disease burden through prevention, diagnosis, and treatment.
As the number of examinations and range of applications of cardiac imaging grows, it becomes more and more important to ensure that healthcare systems are focused on the value radiology provides in improving patient outcomes, rather than simply the number of studies performed2, 5. The fight against cardiac diseases requires action on many fronts, and the radiology profession ensures it contributes in the most impactful and patient-centric way possible.
1 Picano, E. Economic and biological costs of cardiac imaging. In Cardiovasc. Ultrasound, 2005, 3: 13. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1166568/
2 Otero, H.J. et.al. Cost-effective diagnostic cardiovascular imaging: when does it provide good value for the money? In Int J Cardiovascular Imaging, 2010, Aug, 26(6): 605-612. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927101/#R3
3 European Society of Cardiovascular Imaging. European MR/CT Registry 2018. Available at http://www.escr.org/html/img/pool/ESCR_MRCT_18_Booklet_FINAL.pdf
4 World Health Organization. Cardiovascular disease. Available at: http://www.who.int/cardiovascular_diseases/en/
5 Shah, S. et.al. Volume to Value: Defining the Value of Cardiovascular Imaging. In Ochsjner Journal, 2016, 16:203-207. Available at: http://asecho.org/wordpress/wp-content/uploads/2016/10/Shah_Volume-to-Value.pdf
Cardiac Imaging Societies
European Society of Cardiovascular Radiology
North American Society for Cardiovascular Imaging
Asian Society of Cardiovascular Imaging
British Society of Cardiovascular Imaging and British Society of Cardiovascular CT
Société Française d’Imagerie Cardiaque at Vasculaire Diagnostique et Interventionelle
Società Italiana di Radiologia Medica e Interventistica – Sezione Cardioradiologia
Sociedad Mexicana de Ecocardiografía e Imágen Cardiovascular
Indian Association of Cardiac Imaging
Korean Society of Cardiovascular Imaging
Society of Cardiovascular Computed Tomography
Society for Cardiovascular Magnetic Resonance
Society for Magnetic Resonance Angiography
American Society of Echocardiography
Thai Society of Cardiac Imaging