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VIDEO: CT and POCUS Emerge As Frontline Cardiac Imaging Modalities in COVID-19 Era

Coronavirus (COVID-19) | May 07, 2020

Interview with Geoffrey Rose, M.D., president of Sanger Heart and Vascular Institute with Atrium Health, in Charlotte, North Carolina, and a board member with the American Society of Echocardiography (ASE). He explains the impact of COVID-19 (SARS-CoV-2) on the cardiovascular service line and cardiac imaging. He said the virus has led to use of computed tomography (CT) not only as the frontline cardiovascular imaging modality to evaluate chest pain, but also for COVID-19 pneumonia imaging.

Rose said cardiac ultrasound is still used, but requires full personal protective equipment (PPE) and often abbreviated exams because of the close proximity of the sonographer and patient when performing echocardiograms. This has given rise to using dedicated point-of-care ultrasound (POCUS) systems to answer specific clinical questions quickly. Smart-phone based POCUS systems that use an app and a transducer plugged into the phone enable basic echo exams or evaluation of other parts of the anatomy quickly without the need to immediately sterilize an entire cart-based ultrasound system. These small systems also can be completely enclosed inside a transducer sheath and the phone and single transducer are much easier and faster to wipe down. He said the quality of the exams are not as good as fully enabled echocardiography systems, but it allows for quick assessments of ejection fractions and to triage if the patient needs more advanced imaging if the basic questions cannot be answered.

Since hospitals have shut down now for about two months, postponing normal checkups, and elective exams and procedures, Rose said doctors still need to visit with patients who have chronic conditions. Sanger and Atrium Heath modified its ambulatory electronic medical record (EMR) and is using video conferencing to perform virtual appointments now for the majority of these patients. He said telemedicine was not widely used before COVID-19 in his hospital system, but the pandemic will likely alter the care model for the future, with more telemedicine visits being used even after epidemic is over. He said use of POCUS and CT as frontline cardiac imaging modalities will also likely remain in place after the pandemic because of the efficiencies in care these technologies offer.

 

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Cardiac Imaging

Ultrasound Intra-cardiac Echo (ICE) | April 06, 2012

Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging the function of the aortic valve. The technology was shown as a work-in-progress during ACC 2012.

Left Atrial Appendage (LAA) Occluders | April 06, 2012

Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging the left atrial appendage (LAA). The technology may play a role in guiding and properly seating transcatheter LAA occluders. The technology was shown as a work-in-progress during ACC 2012.

Ultrasound Intra-cardiac Echo (ICE) | April 06, 2012

Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging the pulmonary vein. The technology may play a role in better guiding transcatheter electrophysiology (EP) ablation procedures. The technology was shown as a work-in-progress during ACC 2012.

Ultrasound Intra-cardiac Echo (ICE) | April 06, 2012

Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging a transseptal puncture. This new ICE technology may help better guide these punctures, which are routinely used in catheter ablations and transcatheter left atrial appendage (LAA) occluder delivery. The technology was shown as a work-in-progress during ACC 2012.

ACC | March 30, 2012

Diagnostic and Interventional Cardiology Editor Dave Fornell discusses trends and shares his choices of the most innovative technologies shown on the floor of the American College of Cardiology (ACC) 2012 Scientific Session, held March 24-27 in Chicago.

A couple of key trends were evident on the show floor included:

   • New technology to support trans-aortic valve replacement (TAVR);

   • Launch of new cardiovascular image and information systems (CVIS) to support healthcare's adoption of proposed Stage 2 meaningful use (MU) requirements;

   • Balloon-inflatable TAVR/EVAR introducer sheath;

   • 3-D intra-cardiac echo;

   • Mobile angiography system for hybrid ORs;

   • Chocolate for heart health.

 

For more information: www.DIcardiology.com

Cardiac Imaging | December 30, 2011

DAIC editor Dave Fornell explains some of the most innovative cardiovascular imaging technologies showcased by vendors at the Radiological Society of North America (RSNA) meeting in December 2011.

Ultrasound Imaging | December 16, 2011

Toshiba (Canon) unveiled its Aplio 500 ultrasound system at RSNA 2011, , which offers a unique 3-D fly-through imaging capability. The system takes the image dataset and processes it to create a cine loop fly-through of any hollow, fluid-filled blood vessel, duct or organ. The example in this video is of a blood vessel in the liver. The capability and image quality is similar to what is seen in a virtual colonoscopy created from CT datasets. The technology was highlighted in our editor's choice for most innovative new technologies at RSNA 2011. The future applications of this technology may include 3-D ultrasound navigation aids for vessels in the cath lab.

PET-MRI | June 27, 2011

Three companies showed different versions of a combined positron emission tomography (PET)-magnetic resonance (MR) (PET-MRI) system during the Society of Nuclear Medicine (SNM) 2011 annual meeting. Representatives from Siemens, Philips and GE Healthcare explain how their systems work and how PET-MR may be used as a new modality to show both physiologic and anatomical information.

Each company took a different approach to how they create PET-MRI images. Siemens integrated both modalities into one gantry. Philips uses two gantries with a table that moves between the two that maintains patient alignment for fusion imaging. GE Healthcare uses a cot that can move between the MR and PET rooms and fits both systems to maintain alignment and does not require buying a new decicated scanner. 

 

Nuclear Imaging | June 27, 2011

Society of Nuclear Medicine (SNM) President George Segall, M.D., chief of the nuclear medicine service at the VA Palo Alto Health Care System, and is a professor of radiology and professor of cardiology (by courtesy) at Stanford University School of Medicine, offers insights into the trends he saw at the society's 2011 annual meeting.

Trends in nuclear imaging include the creation of PET/MRI systems, use of time of flight (TOF) imaging, new technqiues to image amyloid plaque in Alzheimer's Disease, and the movement toward multimodlaity imaging rather than radiologists specializing in justy one modality.

More nuclear medicine news and video