News | Magnetic Resonance Imaging (MRI) | August 29, 2018

Rapid Cardiac MRI Technique May Cut Costs, Boost Care in Developing World

Shortened MRI exams revealed unsuspected new diagnosis in 19 percent of patients; no additional imaging was required for 89 percent of patients

Rapid Cardiac MRI Technique May Cut Costs, Boost Care in Developing World

August 29, 2018 — A newly developed rapid cardiac imaging protocol quickly and cheaply diagnosed heart ailments in patients in Peru, according to new research in Journal of the American Heart Association1.

In Peru, cardiovascular disease affects 3.2 million (16 percent of the adult population), leading to a significant loss of well-being, estimated at 281,829 Disability Adjusted Life Years.

Current cardiac magnetic resonance imaging (CMR) usage in high-income countries focuses on function, scar, perfusion, flow, mapping and angiography, and delivers valuable clinical insights leading to targeted and precise treatments. However, these varied techniques make it slow (typically 45 minutes), expensive, complex and potentially out of reach for most people in the developing world.

In this study, researchers developed and tested a rapid CMR protocol using contrast dye that  measured cardiac structure, function and scarring. The rapid diagnostics worked with existing infrastructure, took 18 minutes and cost $150 per patient resulting in important changes in patient care.

“Our CMR strategy was three to five times cheaper than current CMR exams in Peru,” said James C. Moon, M.D., study lead author and professor at Barts Heart Centre, St. Bartholomew’s Hospital in London. “It also can be delivered two to three times faster and is easier than conventional CMR.”

Researchers conducted scans on 98 Peruvian patients (average age 52, 60 percent female). Scanning found 26 percent had hypertrophic cardiomyopathy, 22 percent had dilated cardiomyopathy and 15 percent had ischemic cardiomyopathy. Scans also uncovered 12 other pathologies including tumors, congenital heart disease, iron overload, amyloid plaques , genetic syndromes, inflamed vessels, clots and valve disease.

Researchers report CMR revealed an unsuspected new diagnosis in 19 percent of patients or led to a change of treatment in 37 percent. In 5 percent, a change in care management was suggested but not delivered due to access barriers (cardiac surgery or device therapy).

Researchers found rapid CMR satisfied all imaging needs in 89 percent of patients. In 7 percent where CMR was the first imaging technique performed, no further non-invasive imaging was needed. CMR did not miss any diagnoses initially found by echocardiography, researchers said.

“Because the rapid CMR protocol was embedded in clinical care with training and education, it resulted in important and frequent patient management changes that appeared beneficial for both patients and the healthcare system,” said Katia Menacho, Ph.D., study first author and cardiovascular science research fellow at Barts Heart Centre, St. Bartholomew’s Hospital in London. “Lack of resources is not a justification for the absence of key diagnostic tests in the developing world.”

In an accompanying editorial, Christopher M. Kramer, M.D., University of Virginia Health System in Charlottesville noted, “To make this proof-of-principle study a reality in much of the developing world, imagers will need to be trained at sites with appropriate scanner technology. Only in this way will an abbreviated protocol for evaluation of cardiomyopathies be implemented. This is an exciting time for the potential of broadening the impact of CMR throughout the developing world.”

For more information: www.ahajournals.org/journal/jaha

Reference

1. Menacho K., Ramirez S., Segura P., et al. INCA (Peru) Study: Impact of Non‐Invasive Cardiac Magnetic Resonance Assessment in the Developing WorldJournal of the American Heart Association, Aug. 29, 2018. https://doi.org/10.1161/JAHA.118.008981

Related Content

Videos | Cardiac Imaging | September 10, 2018
Leslee Shaw, Ph.D., professor of cardiology and rad
Arterys collaborated with GE Healthcare to create the ViosWorks software to cardiac MRI analysis.

Arterys collaborated with GE Healthcare to create the ViosWorks software. The software integrates artificial intelligence to speed workflow and perform a full 3-D chest volume scan with myocardium motion, blood flow, time and fully automated quantification.

Feature | Cardiac Imaging | March 30, 2018 | Jeff Zagoudis
Magnetic resonance imaging (MRI) for cardiac assessment provides a radiation-free alternative to other commonly used
New Policy Decisions Give Millions Access to HeartFlow FFRct Analysis
News | Cardiac Imaging | February 01, 2018
February 1, 2018 – HeartFlow announced that seven new commercial payers issued positive medical policies covering the
Clear detail of the in-stent restenosis can be seen in this image from the new high-resolution Canon Precision CT system. RSNA 2017, #RSNA2017, #RSNA17

Clear detail of the in-stent restenosis can be seen in this image from the new high-resolution Canon Aquilion Precision CT system.

Feature | Cardiac Imaging | January 23, 2018 | Dave Fornell
Medical imaging plays a key role in cardiology, and most of the newest radiology technology advances are first unveil
Philips Introduces Technology Maximizer Program for Imaging Equipment Upgrades
Technology | Cardiac Imaging | January 17, 2018
Philips recently announced the launch of Technology Maximizer, a cross-modality program designed to boost the clinical...
Videos | Cardiac Imaging | December 29, 2017
ITN and DAIC Editor Dave Fornell takes a tour of some of the most interesting new medical imaging technologies on the
Siemens Healthineers Introduces Share360 Tailored Service Portfolio
News | Cardiac Imaging | November 10, 2017
To address the specific needs of medical imaging clinical engineering departments nationwide, Siemens Healthineers has...
HeartFlow's FFR-CT (FFRct) analysis software can create a virtual FFR to assess coronary artery disease.

HeartFlow's FFR-CT analysis software uses a computed tomography scan and supercomputing fluid dynamics software to create a noninvasive, virtual FFR map of the entire coronary artery tree to determine the flow-limiting severity of ant lesions. 

News | Cardiac Imaging | November 06, 2017
November 6, 2017 – The Centers for Medicare & Medicaid Services (CMS) has finalized a New Technology Ambulatory P
Philips Announces Findings of Patient Experience in Imaging Research
News | Cardiac Imaging | October 24, 2017
Philips recently announced the key findings of its research focused on the patient experience in diagnostic imaging...
Overlay Init