Cardiac Imaging – What Do I Really Need to Know?

Kurzfassung:

The pivotal role of cardiovascular (CV) imaging to the care of patients with heart disease is evident. From technical point of view CV imaging is developing very rapidly. This progress creates new demands on our profession for competence and training. Radiologists should be ready to meet these demands in order to keep cardiac imaging in their hands. Deep knowledge of CV physiology, cardiac diseases and latest advances in CV imaging technologies is a must for any radiologist performing cardiac imaging. In this aspect role of national and international (ESR and ESCR) professional organizations of radiologists becomes more and more important. It is obvious that the need for CV imaging will continue to grow over the coming years due to progress of technology, changes in incidence and scope of CV diseases, aging of population and other reasons. We are witnessing important trends in modern CV imaging, including the move toward multimodality imaging, development of international guidelines on appropriate use and technical standards on different imaging modalities. There were some statements about overuse of CV imaging. In reality more serious problems are underuse and misuse of cardiac radiology. This is why creation and promotion of appropriate use guidelines for CV imaging gains more and more importance to clinical care. More and more clinical trials about different CV imaging modalities are directed to show their additional diagnostic value and cost-effectiveness of healthcare. One of the most spectacular examples is use of coronary CT in patients with acute chest pain admitted to emergency departments. Another good example is increasing use of cardiac MRI for assessment of myocardial perfusion and viability, where this diagnostic modality favorably competes with nuclear myocardial perfusion scans. An updated knowledge about clinical and economical effectiveness of CV imaging is needed if we are to further improve care of patients with diseases of heart and vessels. Radiologists in co-operation with cardiologists and cardiac surgeons should re-design the diagnostic pathways in which imaging modalities are integrated in a cost-effective strategy in the interest of patient health and economy of health care.