At RSNA 2012, Hitachi featured its Echelon Oval 1.5T MRI system, which features the widest bore on the market at 74 cm, a wide table and the ability to perform non-contrast MR angiography exams. Hitachi also highlighted new features for its Scenaria CT system, which is upgradeable to a 128-slice system, offers new, faster iterative reconstruction software and cardiac imaging packages.

Imaging Technology News experts discuss the trends and latest technology they saw on the show floor and in sessions at RSNA 2012. Their discussions include some of the most innovative new devices and software to solve issues facing radiology today.

Mercy Hospital in Chicago developed an interventional program around its hybrid cath labs, fostering collaboration between interventional cardiologists, vascular surgeons and interventional radiologists. This collaboration has helped the hospital improve care and keep costs low in order to serve the Chicago South Side's low-income population. Read the article "Most Innovative Heart Centers: Chicago’s Mercy Hospital." There is also a related VIDEO about Mercy, "Developing a Hybrid Cath Lab Program."

Results from the POSEIDON Trial were presented at Transcatheter Cardiovascular Therapeutics (TCT) 2012. Data showed a positive strategy to prevent contrast-induced nephropathy (CIN) in patients with renal impairment undergoing interventional catheterization procedures. CIN is also referred to as acute kidney injury (AKI). The data is presented in a press conference by Sonjot Brar, M.D., MPH, Kaiser Permanente.

Related CIN Content:

Sliding Scale Hydration Washes Out Contrast-Induced Kidney Complications

Contrast-Induced Kidney Injury Prevented With RenalGuard in REMEDIAL III Trial

VIDEO: How to Avoid Acute Kidney Injury in the Cath Lab — Interview with Hitinder Gurm, M.D.

VIDEO: Strategies to Avoid Acute Kidney Injury Caused by Cath Lab Contrast — Interview with Roxana Mehran, M.D.

The results of the FAME II Trial were presented at the 2012 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The study showed the cost effectveness of fractional-flow reserve (FFR) therapy vs. standard medical therapy.

Diagnostic and Interventional Cardiology Editor Dave Fornell shares his choices of the latest advances in cardiac ultrasound from the show floor of the American Society of Echocardiography (ASE) 2012. With the increasing use of more complex interventional procedures, transesophageal echo (TEE) and intracardiac echo (ICE) are being used for guidance to reduce fluoroscopic radiation dose.

Three big trends were seen in cardiovascular ultrasound during the American Society of Echocardiography (ASE) 2012 meeting. Malissa Wood, M.D., co-director of the Women's Center at Mass General Hospital, Boston, and chair of the ASE Public Relations Committee, explains these trends. The biggest is the expanding use of ultrasound and transesophageal echo (TEE) in the cath lab and hybrid OR for structural heart procedural navigation. Other trends include use of pocket ultrasound and new software advances to simlify and reduce the time it takes to use 3-D echo and make quantifications. For more information: www.dicardiology.com/article/ultrasound-sees-increasing-use-interventional-procedures

To help hospitals upgrade their electrophysiology (EP) reporting systems and integrate EP into cardiovascular and hospital reporting systems, Michael Mirro, M.D., FACC, medical director, cardiology/electrophysiology, Parkview Physicians Group, Ft. Wayne, Ind., offers suggestions of what to look for in systems. He spoke about cardiovascular/EP IT integration and the impact of healthcare reforms during the Heart Rhythm Society (HRS) 2012 scientific sessions.

Diagnostic and Interventional Cardiology Editor Dave Fornell shows some of the most innovative new technology displayed on the show floor at the Heart Rhythm Society (HRS) annual scientific sessions. The tour includes new devices and trends in electrophysiology. For more information: www.DIcardiology.com

Pivitol trial data regarding the safety and efficacy of the Cameron Health Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) system was very positive. The system is currently pending FDA approval and would be the only subcutaneous lead electrophysiology device cleared for use in the United States. The system eliminates the need for venous leads and intra-cardiac securement, greatly simplifying the implant procedure. Data from Cameron Health's IDE trial was presented by Martin Burke, DO, FACC, FACOI, FRCP, director, Heart Rhythm Center, University of Chicago, at the Heart Rhythm Society (HRS) 2012 scientific sessions. For more information: www.DIcardiology.com 

The ACRIN-PA trial showed computed tomography (CT) coronary angiography can be more cost-effective than the standard-of-care in evaluating patients with chest pain in the emergency department. The data was presented by Harold Litt, M.D., during the American College of Cardiology (ACC) 2012 scientific sessions. For more information: www.DIcardiology.com

Related ACRIN-PA Study Content:

VIDEO: CT for Chest Pain Evaluation in The Emergency Department — Interview with Harold Litt, M.D.

VIDEO: ACRIN-PA Trial Showed Benefit of CT in Assessing Chest Pain — Litt explaining the trial.

Coronary CT Angiography is Effective to Evaluate Chest Pain Patients
 

One of the most interesting educational exhibits at the recent American College of Cardiology (ACC) 2012 Scientific Session was "The Heart of Innovation" display on the show floor. The ACC in collaboration with marquee sponsor Philips Healthcare and several other industry leaders created this non-accredited, hands-on education experience. The exhibit explored the evolution of the standard-of-care for heart disease and heart failure caused by valvular disease. It looked at these issues through the lenses of personalized medicine, techno-biology, minimally invasive procedures and physician-patient engagement. The exhibit included technology from the past, present and future of healthcare. To incorporate a historical view, the entrance to the display included the ACC's special collection of historic artifacts encompassing medical books, stethoscopes and device technology dating back hundreds of years, including a stethoscope from 1535. This historical perspective was juxtaposed with a modern attendee experience that included the option to explore the entire exhibit with a specially provided iPad tour. The centerpiece was a mockup of a hybrid OR. It included a Corindus CorPath robotic cath lab intervention guidance system. Other partners included Maquet, showing a portable heart-lung machine the size of a small suitcase and the CFI Medical Solutions ZeroGravity radiation protection system. What made the hybrid OR particularly unique was that it was situated across from the Minimally Invasive Gallery, which featured many of the innovations that are driving procedures performed in the hybrid OR. The gallery encompassed solutions from Medtronic and Edwards Lifesciences, including Edward's breakthrough Sapien transcatheter heart valve. The display discussed current treatments and what the future technologies will likely be from the standard-of-care in the future.

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.

The Crux inferior vena cava (IVC) filter was designed for easy deployment and later retrival. This video clip shows deployment of the device, which has has radio-opaque markets for easier visualization under angiography. IVC filters are designed for the prevention of pulmonary embolism.

The Crux inferior vena cava (IVC) filter was designed for easy deployment and later retrieval. This video clip shows retrieval of the device, which has has radio-opaque markets for easier visualization under angiography. IVC filters are designed for the prevention of pulmonary embolism.

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

New evidence shows that with appropriate preparation, angioplasty can be safely and effectively performed at community hospitals without on-site cardiac surgery units. This was according to data presented from the CPORT-E trial during the American College of Cardiology (ACC) 2012 Annual Scientific Session. The study is the first randomized controlled trial to investigate elective cath lab angioplasty (or percutaneous coronary intervention, which includes stenting and balloon angioplasty) in community hospitals in the United States.

Results showed no difference in death rates among patients undergoing elective angioplasty at facilities with and without on-site cardiac surgery units. There were also no significant differences in rates of complications such as bleeding, renal failure and stroke.

"The study shows that under certain circumstances, non-primary angioplasty can be performed safely and effectively at hospitals without on-site cardiac surgery," said Thomas Aversano, M.D., associate professor of cardiology at Johns Hopkins University and the study's lead investigator.

Until a recent guideline change by the American College of Cardiology and the American Heart Association, community hospitals without cardiac surgery units performed only emergency angioplasties. Patients needing elective angioplasty were transferred to facilities with on-site cardiac surgery units.

"The study supports and reinforces the [new] guidelines," said Aversano, adding that the findings can help hospitals and healthcare planners more efficiently allocate financial and human resources. The ability for community hospitals to offer elective angioplasty benefits patients, Aversano said. Other studies have shown that patients are often reluctant to transfer to a hospital that may be farther away or more expensive than their community hospital. "It's not just a question of patient convenience — it's also a question of access," he said.

Read the article On-Site Cardiac Surgery Not Required for Safe, Effective PCI
 

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.

The Miracor Picso Impulse system is supposed to prevent reperfusion injury and the no-flow phenomenon following percutaneous coronary intervention (PCI) by increasing the microcirculation in the ischemic area. The device uses a balloon catheter in the coronary sinus to temporarily increase venous blood pressure.

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.