Matthew Budoff, M.D., director of cardiovascular CT at The Lundquist Institute, and professor of medicine at the David Geffen School of Medicine at UCLA, presented the  EVAPORATE Study final results at the European Society of Cardiology (ESC) 2020 Congress. He explains how cardiac CT was used to monitor patients taking icosapent ethyl (Vascepa) showed it showed a 17 percent reversal of low attenuation plaques in the coronary arteries.

Final results from Effect of Icosapent Ethyl on Progression of Coronary Atherosclerosis in Patients with Elevated Triglycerides on Statin Therapy (EVAPORATE) Trial showed a significant reduction in the primary endpoint of icosapent ethyl reducing LAP plaque volume from baseline. Whereas there was a progression of LAP plaque volume in the placebo group. There were significant differences between icosapent ethyl and placebo at study end for secondary endpoints of other types of plaque volume changes, including and sequentially total, total non-calcified, fibrofatty, and fibrous plaque volumes. All regressed in the icosapent ethyl group and progressed in the placebo group, (p<0.01 for all). The only secondary endpoint which did not achieve a significant difference between groups in multivariable modeling was dense calcium (p=0.053).

Read more in the article "Icosapent Ethyl Significantly Reduces Coronary Plaque in EVAPORATE Study."

Find more ESC news

This is a tutorial video on how to perform an artificial intelligence (AI) automated cardiac ejection fraction measurement using the GE Healthcare Vscan Extend point-of-care ultrasound (POCUS) system and the LVivo EF app, developed and licensed by DiA Imaging Analysis. This FDA-cleared app enables an automated edge detection of left ventricular endocardium and calculates end-diastolic, end-systolic volumes and ejection fraction, using apical 4-chamber view.

the LVivo EF app was showcased by GE Healthcare in its virtual booth at the American Society of Echocardiography (ASE) 2020 virtual meeting. POCUS imaging has emerged as a primary imaging modality for bedside assessment of COVID-19 patients in 2020.

Related ASE News and POCUS Content:

VIDEO: Automated Cardiac Ejection Fraction for Point-of-care-ultrasound Using Artificial Intelligence

LVivo EF Comparable to MRI, Contrast Echo in Assessing Ejection Fraction

GE Highlights New Echocardiography Technologies at ASE 2020

Other ASE news and video

Todd Villines, M.D., FACC, FAHA, MSCCT, explains how artificial intelligence (AI) might be used in the near future to automatically calculate CT calcium scoring and radiomic feature assessments. This was a key take away during the Society of Cardiovascular Computed Tomography (SCCT) 2020 virtual meeting. 

Villines is the Julian Ruffin Beckwith Professor of Medicine, Division of Cardiovascular Medicine, University of Virginia, editor-in-chief of the Journal of Cardiovascular CT (JCCT),  and SCCT past-president.

AI is already commercially used to improve CT image reconstruction to increase the diagnostic quality of the images, especially from low-dose scans. AI is now being applied to automate time-consuming tasks in CT image reads, such as manually calculated calcium scores and automated contouring and quantification of anatomy and function of the heart.

Another area that is seeing a lot of research in in radiomics, where AI is being used to sift through thousands of CT scans to look for subtle imaging traits that may indicate the early development or worsening of disease. These subtle changes may not be evident to radiologists reading the scans, but AI software can identify similarities in patients as a trend and alert researchers to look at that specific trait as a potential imaging biomarker.

Other Key Trends and Technology at SCCT:

Top 9 Cardiovascular CT Studies in Past Year 

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

VIDEO: Increased Use of Cardiac CT During the COVID-19 Pandemic

VIDEO: Key Cardiac CT Papers Presented at SCCT 2020

Low-attenuation Coronary Plaque Burden May Become Next Big Cardiac Risk Assessment

Impact of Cardiac CT During COVID-19

VIDEO: Artificial Intelligence to Automate CT Calcium Scoring and Radiomics

Todd Villines, M.D., FACC, FAHA, MSCCT, explains some of most influential cardiac CT clinical papers from the past year at the Society of Cardiovascular Computed Tomography (SCCT) 2020 virtual meeting. Among these were the ISCHEMIA Trial, others showing the value of CT is assessing chest pain patients and its ability to act as a gate keeper to the cath lab, and the 2019 European Society of Cardiology (ESC) guidelines that now list cardiac as a preferred imaging modality.

Villines is the Julian Ruffin Beckwith Professor of Medicine, Division of Cardiovascular Medicine, University of Virginia, editor-in-chief of the Journal of Cardiovascular CT (JCCT), and SCCT past-president.

Other Key Trends and Technology at SCCT:

Top 9 Cardiovascular CT Studies in Past Year 

VIDEO: Increased Use of Cardiac CT During the COVID-19 Pandemic

VIDEO: Coronary Plaque Quantification Will Become Major Risk Assessment

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

VIDEO: Artificial Intelligence to Automate CT Calcium Scoring and Radiomics

Low-attenuation Coronary Plaque Burden May Become Next Big Cardiac Risk Assessment

Impact of Cardiac CT During COVID-19

Todd Villines, M.D., FACC, FAHA, MSCCT, explains some of the discussion on CT used for COVID-19 patients at the Society of Cardiovascular Computed Tomography (SCCT) 2020 virtual meeting in July. He is the Julian Ruffin Beckwith Professor of Medicine, Division of Cardiovascular Medicine, University of Virginia; editor-in-chief of the Journal of Cardiovascular CT (JCCT), and SCCT past-president. 

Early on in the COVID-19 pandemic in China, CT emerged as a key imaging modality and was found to be able to detect COVID ground glass lesions in the lungs sometimes prior to positive genetic PCR test results. Supporters of CT say the modality offers a way to get detailed anatomical and functional information using a short exam time and limits the exposure of staff to potential or known COVID-19 positive patients.

One area where cardiac CT is seeing a lot of increased his is for the evaluation of thrombus in the left atrial appendage (LAA). This is traditionally done using transesophageal echo (TEE), but it required very close contact with the patient and direct exposure of staff to bodily fluids and potential viral shed from the patient exhaling with each breath.

Related CT During COVID-19 Content:

Cardiac Imaging Best Practices During the COVID-19 Pandemic

VIDEO: CT and POCUS Emerge As Frontline Cardiac Imaging Modalities in COVID-19 Era — Interview with Geoffrey Rose, M.D.,

ASE Guidelines for the Protection of Echocardiography Providers During the COVID-19 Outbreak 

Study Looks at CT Findings of COVID-19 Through Recovery

Experts Stress Radiology Preparedness for COVID-19

ACR Recommendations for the Use of Chest Radiography and CT for Suspected COVID-19 Cases

Impact of Cardiac CT During COVID-19

Other SCCT Key Trends and New Technology Content:

Top 9 Cardiovascular CT Studies in Past Year 

VIDEO: Coronary Plaque Quantification Will Become Major Risk Assessment

VIDEO: Key Cardiac CT Papers Presented at SCCT 2020

VIDEO: Photon Counting Detectors Will be the Next Major Advance in Computed Tomography

VIDEO: Artificial Intelligence to Automate CT Calcium Scoring and Radiomics

Low-attenuation Coronary Plaque Burden May Become Next Big Cardiac Risk Assessment

Interview with Andrew D. Krahn, M.D.,FHRS, head of the division of cardiology at St. Paul’s Hospital, and professor of medicine at the University of British Columbia, and vice president of the Heart Rhythm Society (HRS). He is an expert in long QT syndrome (LQTS) and is involved with the National Long QT Registry. He explains the issues with the drugs being used to treat coronavirus (COVID-19, SARS-CoV-2) patients and why these combined with the cardiac impact of the virus is causing prolonged ECG QT segment prolongation, leading to deadly arrhythmias. COVID-19 can cause myocarditis that causes QT prolongation and the front-line COVID drugs hydroxychloroquine and azithromycin also cause QT prolongation.

The U.S. Food and Drug Administration (FDA) issued a Drug Safety Communication April 23, 2020, reminding doctors there are serious side effects when using hydroxychloroquine and chloroquine in the off-label use to treat COVID-19 patients. This includes potentially life-threatening heart rhythm problems. The FDA said case reports from the FDA Adverse Event Reporting System database, published medical literature and the American Association of Poison Control Centers National Poison Data System are reporting serious heart-related adverse events and patient deaths. Read more about this alert.

The FDA warning confirmed fears from the American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS). These societies April 8 jointly published a new guidance, “Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 19) Treatment,” to detail critical cardiovascular considerations in the use of hydroxychloroquine and azithromycin for the treatment of COVID-19. The societies warned that use of  these agents in a large number of patients in combination would results in arrhythmias and deaths. Read more.

However, there are numerous advocates that argue hydroxychloroquine needs to be used in less sick patients who are not already hypoxic to treat COVID, but it is being used primarily in very sick patients where it is not effective. Advocates also argue the drug can be used to help prevent coronavirus, similar to the drug's effect in preventing malaria. In terms of drug safety, advocates argue the drug has been used in millions of patients for more than 50 years without a high risk of arrhythmias. Several trials are now underway in the United States to test its use against COVID-19, but enrollment has been hampered because of the FDA warning. There will likely be more interest in hydroxychloroquine after it was revealed May 18, 2020, that President Trump is taking the drug for prophylaxis against COVID-19.

Related Hydroxychloroquine Content:

FDA Revokes Emergency Use Authorization for Chloroquine and Hydroxychloroquine for COVID-19

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WHO Database Shows Serious Health Impact of Hydroxychloroquine and Azithromycin Being Used to Treat COVID-19

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

FDA Reports of Deaths and Injuries From Use of Antimalarial hydroxychloroquine in COVID-19 Patients

VIDEO: Cardiologists Manage Trial Testing if Hydroxychloroquine Protects Clinicians From COVID-19 — Interview with William O'Neill, M.D.

First Large-scale U.S. Study on Hydroxychloroquine COVID-19 Prophylaxis Begins in Detroit

AHA, ACC, HRS Caution Use of COVID-19 Therapies Hydroxychloroquine and Azithromycin in Cardiac Patients

Andrew D. Krahn, M.D., FHRS, head of the division of cardiology at St. Paul’s Hospital, professor of medicine  at the University of British Columbia and vice president of the Heart Rhythm Society (HRS), explains how HRS organized its virtual meeting after its in-person meeting was cancelled by the COVID-19 pandemic.  

Due to the continued global escalation of the novel coronavirus (COVID-19, SARS-CoV-2), HRS has cancelled its large annual in-person electrophysiology meeting in late-March and began planning for a virtual meeting instead. HRS broke its annual meeting into three online learning sessions over the course of May June and July. The first, which included the late-breaking sessions, was held May 5-9, 2020. Others will be held June 12 and July 1.

Using its online learning platform, Heart Rhythm 365 available on the www.hrsonline.org website, HRS is offering all its sessions at no cost.

Watch another interview with Krahn in the VIDEO: Top New EP Technologies at Heart Rhythm Society 2020.
 

Find a complete list of the Heart Rhythm 2020 meeting late-breaking studies with links to articles on each.
 

Thomas Maddox, M.D., MSc, FACC, the chair of the American College of Cardiology (ACC) Science and Quality Committee, explains concerns by ACC in a large drop in ST-elevation myocardial infarction (STEMI) heart attacks and strokes since the U.S. spread of COVID-19. Maddox is also the executive director of the Healthcare Innovation Lab of BJC Healthcare and Washington University School of Medicine, St. Louis. He is also an assistant professor of cardiology at Washington University.

The ACC is concerned about the 35-40 percent drop in STEMI and stroke patients presenting to emergency rooms across the U.S. and internationally since the start of the novel coronavirus (COVID-19, SARS-CoV-2) pandemic. Maddox is alarmed by the drop in cases and suspects patients are deciding to stay home rather than go to the hospitals out of fear about catching COVID-19. ACC launched a public relations campaign April 14, 2020, aimed at the public to get them to call 911 or go to hospitals if they have symptoms of stoke of a heart attack. Maddox said hospitals are still seeing and treating non-COVID-19 patients and the cardiovascular departments are still activating their cath labs to handle and acute cardiac cases that come in. 

He said Spain, which was hit earlier than the U.S. by the virus, saw a STEMI case decrease of about 40 percent. Based on limited U.S. data, he said U.S. cath lab activations are down about 35 percent. A clearer picture of the actual numbers of STEMI and other PCI cases will not be known from the ACC National Cardiovascular Data Registry (NCDR) until later this year, since most hospitals pull this data quarterly.

ACC is offering resources for the public  at www.cardiosmart.org/Coronavirus to evaluate their symptoms and help decide it they should go to the hospital or call 911.

Read the related article "Rapid Drop in Heart Attacks and Stroke at Hospitals Concerns ACC."

Watch another interview with Maddox in the VIDEO: What Cardiologists Need to Know about COVID-19.

Stephen Bloom, M.D., FASNC, director of nonivasive cardiology (cardiac CT, nuclear cardiology and echocardiography) at Midwest Heart and Vascular Associates, Overland Park, Kansas. He is also a member of the American Society of Nuclear Cardiology (ASNC) Board of Directors, explains some of the issues involved and protocols used for cardiac imaging during the COVID-19 pandemic. His discussion includes computed tomography, cardiac ultrasound and nuclear imaging.

Right now, Bloom said it is difficult to test everybody and there is a shortage of masks, gowns and other personal protective equipment (PPE), and the imaging equipment needs to be sanitized each time it is used. He said it is just is not possible to image all the patients who need imaging right now. Hospitals also are trying to limit the number of healthy people people coming into hospitals for routine visits and tests to reduce their potential exposure to the novel coronavirus (COVID-19, SARS-CoV-2) and help containment efforts. 

"The tests should be done, very simply, if it changes the care of the patient. If it doesn't change the care of the patient, and it can be postponed, it should be postponed," Bloom explained. "I would say 80 percent of our cardiac imaging exams have stopped. It has been very dramatic."

Related Imaging Precautions During COVID-19 Content:

Cardiac Imaging Best Practices During the COVID-19 Pandemic

Best Practices for Nuclear Cardiology Laboratories During the Coronavirus (COVID-19) Pandemic

ASE Guidelines for the Protection of Echocardiography Providers During the COVID-19 Outbreak 

VIDEO: Best Practices for Nuclear Cardiology During the COVID-19 Pandemic — Interview with Hicham Skali, M.D.

VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak — Interview with Ehtisham Mahmud, M.D. 

VIDEO: 9 Cardiologists Share COVID-19 Takeaways From Across the U.S.  

VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19 — Interview with Regina Druz, M.D.

VIDEO: Use of Teleradiology During the COVID-19 Pandemic — an interview with radiologist John Kim, M.D.

Study Looks at CT Findings of COVID-19 Through Recovery

Experts Stress Radiology Preparedness for COVID-19

VIDEO: Imaging COVID-19 With Point-of-Care Ultrasound (POCUS) — Interview with emergency physician Mike Stone, M.D.,

VIDEO: How China Leveraged Health IT to Combat COVID-19 — Interview with Jilan Liu, M.D., CEO for the HIMSS Greater China

ACR Recommendations for the Use of Chest Radiography and CT for Suspected COVID-19 Cases

VIDEO: What Cardiologists Need to Know about COVID-19 — Interview with Thomas Maddox, M.D.

The Cardiac Implications of Novel Coronavirus

Hicham Skali, M.D., a staff cardiologist and member of the Non-invasive Cardiovascular Imaging Program at Brigham and Women’s Hospital (BWH), and at Brigham and Women’s / Massachusetts General Health Care Center at Foxborough, explains the new recommendations from the American Society of Nuclear Cardiology (ASNC) and from imagers in China and Singapore. The ASNC created a best practices document for nuclear cardiology laboratories during the novel coronavirus (COVID-19, SARS-CoV-2) pandemic. The suggestions in the guidelines can ally to any imaging modality, including computed tomography (CT), MRI and ultrasound. 

Skali elaborates on the following points in his discussion, which are specific recommendations in the ASNC and SNMMI COVID-19 guidance document:
   • Rescheduling non-urgent visits
   • Rescheduling elective surgeries and procedures
   • Using separate spaces for patients with known or suspected COVID-19 to prevent spread
   • Ensuring supplies are available
   • Promoting use of telehealth
   • Screen staff, patients and visitors before they enter the department
   • Minimize non-essential visitors into the department
   • Record symptoms at the start of the shift
   • Use personal protective equipment (PPE)for healthcare personnel
   • If available, use PPE for patients due to concern of asymptomatic transmission of COVID-19
   • Maintain strict hand hygiene
   • Maintain 6 feet distance in all patient/staff interactions when possible
   • Work remotely whenever feasible, especially with ready studies
   • Rotating staff schedules for on-site and off-site work
   • Use of rest only studies if possible
   • Use of half-time SPECT to speed exam times
   • Use of PET if available to speed exam times

Skali served as the moderator in for the ASNC on demand webinar COVID-19 Preparedness for Nuclear Cardiology Labs: Insights from the US, China and Singapore.

VIDEO: Telemedicine in Cardiology and Medical Imaging During COVID-19 — Interview with Regina Druz, M.D., an ASNC Board member and also a speaker during the ASNC webinar.

Find more news and video on relating to COVID-19 and its impact on cardiology

A review of the PARTNER 3 Low-Risk Trial with Michael Mack, M.D., chairman, cardiovascular service line,  Baylor Scott and White Health, Dallas Texas, chairman of the board of the BSW Health Research institute, Dallas, and co-principal investigator of the trial. The PARTNER 3 Low-Risk Trial two-year data were presented as a late-breaking study at the virtual American College of Cardiology (ACC) 2020 annual meeting. The trial offers additional evidence that TAVR performs as well as surgery in select low-risk patients. 

Mack said the trial included patients over the age of 65, and there is still a question about long-term durability of the Sapien 3 TAVR valve used in trial before it is used in younger patients. He said patients in this trial will be tracked out to 10 years, which will offer a lot of information on durability of the current iteration of this valve. In the video, he also elaborates on TAVR issues involved with bicuspid aortic valves and other patient selection issues.

PARTNER 3 enrolled 1,000 patients with severe aortic stenosis and a Society of Thoracic Surgeons (STS) risk score of less than 4 percent. All patients had a tricuspid aortic valve. Half of the participants were randomly assigned to undergo TAVR and half underwent surgery. At two years, 11.5 percent of patients receiving TAVR and 17.4 percent of those receiving surgery died, suffered a stroke or were rehospitalized for cardiovascular problems, a difference in the composite primary endpoint that researchers reported as showing non-inferiority, meaning neither treatment was superior to the other.

In a secondary analysis, rates of death and stroke were found to be not significantly different between the two groups. Death occurred in 2.4 percent of those receiving TAVR and 3.2 percent of those receiving surgery, while stroke occurred in 2.4 percent of those receiving TAVR and 3.6 percent of those receiving surgery. Rehospitalization rates showed a significant difference in favor of TAVR; 8.5 percent of those receiving TAVR and 12.5 percent of those receiving surgery were rehospitalized for cardiovascular reasons during the study period. 

Read more details about this trial 

Read the one year trial results from ACC 2019

Find other ACC news and videos
 

Interview with Thomas Maddox, M.D., MSc, FACC, the chairman of the American College of Cardiology (ACC) Science and Quality Committee, which recently created the ACC document on novel coronavirus (COVID-19) clinical guidance for the cardiovascular care team. He explains the document and what cardiologists and the cardiac care team needs to know about caring for COVID-19 patients. The document points out COVID-19 combined with the comorbidity of cardiovascular disease has the mortality of any comorbidity, as high as 10.5 percent.

He explains the need for more serious attention to protective equipment, cardiovascular complications seen in COVID-19 (SARS‐CoV‐2) patients, suggestions on how to mitigate exposure if an echo or cath is required, and other considerations for the CV care team. He said the document will be updated on a regular bases and the committee is drafting other sets of related COVID-19 guidelines for cardiology departments.

Updates regarding COVID-19 and cardiology will be posted on the ACC COVID-19 Hub page.

Maddox is also the executive director of the Healthcare Innovation Lab of BJC Healthcare and Washington University School of Medicine, St. Louis. He is also an assistant professor of cardiology at Washington University.

Read more on ACC COVID-19 recommendations for the cardiovascular care team.

Additional COVID-19 Resources for Clinicians:

   World Health Organization (WHO) COVID-19 situation reports

   World Health Organization (WHO) coronavirus information page

   U.S. Food and Drug Administration (FDA) COVID-19 information page

   Centers for Disease Control (CDC) COVID-19 information page

   Centers for Medicare and Medicaid Services (CMS) frequently asked questions and answers (FAQs) for healthcare providers regarding COVID-19 related payments
 

Related COVID-19 Content:

The Cardiac Implications of Novel Coronavirus

ESC Council on Hypertension Says ACE-I and ARBs Do Not Increase COVID-19 Mortality

CT Provides Best Diagnosis for Novel Coronavirus (COVID-19)

Radiology Lessons for Coronavirus From the SARS and MERS Epidemics

Deployment of Health IT in China’s Fight Against the COVID-19 Epidemic

Emerging Technologies Proving Value in Chinese Coronavirus Fight

Radiologists Describe Coronavirus CT Imaging Features

Coronavirus Update from the FDA

CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia

CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV)

Chest CT Findings of Patients Infected With Novel Coronavirus 2019-nCoV Pneumonia 

Karen Ordovas, M.D., MAS, professor of radiology and cardiology at the University of California San Francisco (UCFS) School of Medicine and a Society of Cardiac Magnetic Resonance (SCMR) board member, explains how cardiac MRI can help in women's heart disease and to better define complex congenital heart anatomy. She spoke at the 2019 Radiological Society of North America (RSNA) meeting. 

She specializes in cardiac and pulmonary imaging, and has particular expertise in using CT and MRI techniques in cardiovascular imaging and the differences of presentation in imaging between male and female cardiac patients. Ordovas is helping advance education around heart disease in women and bring great awareness of quality tools to diagnose heart disease and how heart MRI can help. She also is heavily involved in the use of heart MRIs for pregnant women, since there is no radiation,  and patients with congenital heart disease where detailed imaging of the complex anatomy is required.

The use of cardiac MRI in congenital heart disease is common in serial imaging of patients with Tetralogy of Fallot (TOF), one of the most common congenital heart diseases for which patients are referred for post-operative magnetic resonance (MR) imaging evaluation. In the past few decades, surgery has proved successful, but most patients require repeat imaging throughout their lives and MRI can offer more detailed soft tissue imaging without the use of radiation. 

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Advantages and New Applications of Cardiac MRI

Will Cardiac MRI Expand?

Mahadevappa Mahesh, Ph.D., chief of medical physicist and professor of radiology and medical physics, Johns Hopkins University, Baltimore, treasurer of the American Association of Physicists in Medicine (AAPM),a board member of the American College of Radiology (ACR), presented a late-breaking study on how medical imaging radiation dose has started to drop over the past decade. He is the co-chair of the National Council on Radiation Protection and Measures Report (NCRP), and presented the most recent NCRP data analysis at the 2019 Radiological Society of North America (RSNA) meeting.

The new NCRP 184 report covers the period between 2006 and 2016, the period of the most current CMS data. It shows a decrease of about 20 percent in the radiation dose the U.S. population receives from medical imaging, compared to the NCRP 160 that covered the period of up to 2006.

Key findings of the study include:

   • CT dose dropped about 6 percent, despite a 20 percent increase CT scans since 2006;

   • Drop of more than 50 percent for nuclear imaging scans, mainly due to fewer procedures begin performed;

   • A 15-20 percent decrease across X-ray imaging modalities.

Mahesh says this shows the impact of using "as low as reasonably achievable" (ALARA) principals, new dose guidelines outlined jointly by numerous medical societies, and dose reduction initiatives like Image Wisely, Image Gently, and the American College of radiology (ACR) Dose Index Registry.

He said there was growing concern a decade ago when the last council report was published, which show a steep increase in radiation dose. This was mainly due to a rapid increase in the use of computed tomography (CT) and other types of X-ray based and nuclear radiotracer medical imaging. This prompted the ACR top create the Image Wisely program and push for the use of more thoughtful imaging doses based on patient size, using the "as low as reasonably achievable” (ALARA) principle. While CT dose was lowered, he said the biggest decline was in nuclear imaging.

DAIC Editor Dave Fornell and Imaging Technology News (ITN) Consulting Editor Greg Freiherr offer a post-game report on the trends and technologies they saw on the expo floor of 2019 Radiological Society of North America (RSNA) annual meeting. This includes artificial intelligence (AI), augmented reality, holographic imaging, cybersecurity, and advances in digital radiography (DR) with a glassless detector plate, X-ray tomosynthesis, dual-energy X-ray and dynamic DR imaging. 

Find RSNA news and other videos

Piotr J. Slomka, Ph.D., FACC, research scientist in the Artificial Intelligence in Medicine Program, Department of Medicine at Cedars-Sinai, and professor of medicine in-residence of the David Geffen School of Medicine, UCLA. He explains how his team at Cedars-Sinai is working on intelligent patient risk prediction algorithms that will automatically extract information from medical imaging. He spoke on artificial intelligence (AI) development for medical imaging in sessions at the 2019 American Society of Nuclear Cardiology (ASNC) annual meeting. 

Find more articles and video on AI

Rupa Sanghani, M.D., FASNC, associate professor, Rush Medical College, director of nuclear cardiology and stress laboratory, Rush University Medical Center, and associate director, Rush Heart Center for Women, explains how to create a high-volume cardiac positron emission tomography (PET) imaging program. She spoke on this topic at the 2019 meeting of the American Society Nuclear Cardiology (ASNC) and led a tour for attendees of the PET-CT system at Rush, which was located close to the conference. 

Sanghani said the advantages of PET myocardial perfusion imaging include faster exam times and allowing additional information from coronary reserve flow assessments to better understand if revascularization will help a patient's heart recover. The 16-slice CT scanner is used not only to attenuate the PET images, but to perform a CT calcium scoring exam to assess the patient's risk for future cardiovascular events. The Rubidium-82 radiotracer used for PET exams only has a 75 second half life, so it can help increase the number of exams a center is able to perform each day. At higher volume centers, PET is optimized to handle all the patients who require pharmacological stress exams. 

In the video, Sanghani  outlines what Rush did to design its room, covers basics on training, what to look for in a scanner and other considerations when creating a PET program.

Read the article How to Start a Cardiac PET-CT Imaging Program, which includes more information from the Rush PET program.
 

Find more coverage of the ASNC

Find more news on nuclear imaging

Sunil Rao, M.D., chief of cardiology, Durham VA Health System and a professor at Duke University, and Prashant Kaul, M.D., director of the cath lab, Piedmont, Atlanta, discuss trends in radial access at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. They discuss how radial access adoption has grown rapidly in the past few years and now makes up between 40-50 percent of percutaneous coronary intervention (PCI) procedural volume in the United States. They also discuss recent clinical trial data and the new concept of using distal radial access. 

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Radial Access Adoption in the United States
 

Roxana Mehran, M.D., FACC, FACP, FCCP, FESC, FAHA, FSCAI, professor of medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute at Mount Sinai School of Medicine, explains the use of short dual antiplatelet therapy (DAPT) in minorities from the PLATINUM Diversity Trial. The first trial data was released in 2017, and she presented new data from the study at the 2019 Transcatheter Cardiovascular Therapeutics (TCT) meeting. 

The study looked at use of the Promus Element Plus Post-Approval Study and the clinical impact of dual-antiplatelet therapy (DAPT) cessation within 12 months of drug-eluting stent implantation in caucasians and minorities. It is one of the first large trials to stress the importance of diversity in clinical trials, which tent to reflect a population of older white men.

Find more news and videos from TCT 2019