At RSNA 2016, the key buzzwords were “deep learning,” “machine learning” and “artificial intelligence.” Vendors and major academic centers are developing a wide array of artificial intelligence neuro networks to aid radiologists in clinical diagnosis and clinical decision support. Here are two examples of how the IBM Watson system examines a mammography and cardiac patient imaging studies. Watch the VIDEO “Development of Artificial Intelligence to Aid Radiology,” an interview with Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explaining the basis of artificial intelligence in radiology.
VIDEO: An Overview of PFO Closure to Treat Cryptogenic Stroke
Karen Orjuela, M.D., assistant professor of neurology at the University of Colorado Stroke and Brain Aneurysm Center, explains the heart-brain team approach to screening cryptogenic stroke patients for transcatheter patent foramen ovale (PFO) closure.
Related PFO Closure Content:
VIDEO: How Transcatheter PFO Closure Can Reduce Cryptogenic Stroke — Interview with
John Rhodes, M.D., on the REDUCE PFO Trial
VIDEO: PFO Closure Found Beneficial for Cryptogenic Stroke — Presentation of RESPECT Trial results by John Carroll, M.D.
Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains what is known about MRI contrast retention in the brain and other MRI safety concerns. He spoke to ITN at RSNA 2016. Read the article "Gadolinium May Remain in Brain after Contrast MRI."
Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explains the basis of the utilization of artificial intelligence (aka deep learning and machine learning) in radiology. He also explains where things are at in development of these neuro networks at RSNA 2016. Watch the VIDEO “Examples of Artificial Intelligence in Medical Imaging Diagnostics.”
A post-game roundup by Imaging Technology News (ITN) Contributing Editor Greg Freiherr and Diagnostic and Interventional Cardiology (DAIC) and ITN Editor Dave Fornell on the trends and new tech seen on the show floor at the Radiological Society of North America (RSNA) 2016 meeting.
Shimadzu's latest generation interventional lab angiography imaging system, the Trinias, enables advanced imaging capabilities, including reduced patient dose, 3-D rotation angiography acquisitions table side, and stent enhancement software. This video tour of the system was created at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting. For more information: www.shimadzu.com/med/products/angio/index.html.
Corindus Vascular Robotics received U.S. Food and Drug Administration (FDA) 510(k) clearance for its CorPath GRX, the second generation of its vascular robotic system. The system builds upon the original CorPath platform, adding a significant number of key upgrades that increase precision, improve workflow and extend the capabilities and range of interventional procedures that can be performed robotically. These features include Active Guide Management, which enables control of the guide catheter along with robotic control of the guidewire and balloon or stent catheter, with 1 millimeter advancement, from the Control Console. This precise positioning will enable physicians to adjust guide catheter position during PCI procedures, and may expand use of CorPath to more complex cases. The new system also features a completely redesigned Bedside Unit, featuring an Extended Reach Arm and a touchscreen display to streamline workflow. The CorPath GRX was displayed for the first time at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 conference. Read more about the FDA approval.
DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies he found at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 meeting. Watch the related VIDEO “Editor's Choice of the Most Innovative New Technologies at TCT 2015.”
A discussion with Juan Granada, M.D., about transcatheter mitral valve advancements and device challenges at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Granada is executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with Torsten Vahl, M.D., about advancements in transcatheter valve repair technology, including new devices for the aortic, mitral and tricuspid valves. Vahl is director of experimental and translational research and assistant professor of medicine, Columbia University Medical Center, Center for Interventional Vascular Therapy. The interview took place at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting.
Related Transcatheter Valve Content:
VIDEO: Update of Mitral Valve Repair and Replacement Technologies at TCT 2017 — Interview with Ted Feldman, M.D.,
VIDEO: Tricuspid Device Clinical Trial Overview — Interview with Ori Ben-Yehuda, M.D.
VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand at ASE 2018— Interview with Rebecca Hahn, M.D.
VIDEO: TAVR for Degenerated Surgical Valves - 2017 Update— Valve-in-Valve TAVR Procedures — Interview with Sammy Elmariah, M.D.
VIDEO: The Essentials of CT Transcatheter Valve Imaging — Interview with Jonathon Leipsic, M.D.
VIDEO: TAVR For Asymptomatic Severe Aortic Stenosis — Interview with Philippe Genereux, M.D.
VIDEO: Conscious Sedation for TAVR Procedures — Interview with Mario Goessl, M.D.
A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidewire design and function. He is, assistant professor of medicine, Columbia University Medical Center, and director of CTO, complex and high-risk angioplasty program at the Center for Interventional Vascular Therapy, NewYork Presbyterian Hospital. He spoke with DAIC at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Understanding the Design and Function of Guidewire Technology.”
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to evaluate chest pain patients in the emergency department. He is chairman of the Department of Cardiovascular Medicine at Beaumont Health System and a professor of Medicine at the Oakland University William Beaumont School of Medicine. He discussed the first year of experience with FFR-CT at Beaumont Hospital in Royal Oak, Mich., during the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Clinical Applications of FFR-CT.”
A discussion with Todd Brinton, M.D., about the newly FDA-cleared Shockwave Medical Lithoplasty System, at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Brinton is clinical associate professor and adjunct associate professor of bioengineering at Stanford University Medical Center. Read the article “FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound.”
William Abraham, M.D., FACC, discusses advances in heart failure device treatment technologies at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He is director of the division of cardiovascular medicine and a professor of internal medicine, physiology and cell biology at The Ohio State University Wexner Medical Center. He also served as principal investigator of the CHAMPION Trial for the CardioMEMS device. Read the article "Reducing Heart Failure Readmissions."
A discussion with Michael Reardon, M.D. about the state of transcatheter aortic valve replacement (TAVR) as of late 2016. He is a professor of cardiothoracic surgery at Houston Methodist DeBakey Heart and Vascular Center, was the chairman of the patient screening committee for the CoreValve U.S. pivotal trial, nation PI on the Lotus Pivotal Trial, and the national PI of the ongoing the CoreValve intermediate and low-risk trials. Read more in the article "Trends in Transcatheter Aortic Valve Replacement (TAVR)."
Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance of building a good heart team and how that team should interact. They gave a presentation on image guidance for structural heart procedures at TCT 2016, but focused repeatedly on the need for close collaboration to be successful. Read more in the article "Requirements for Interventional Echocardiographers."
Juan Granada, M.D., executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation, explains the shortcomings of the first bioresorbable stent on the U.S. market, proper patient selection and what new BRS technologies are in development. Granada presented numerous sessions on bioresorbable scaffolds at TCT 2016. Read more about bioresorbable stents in "Tempering the Bioresorbable Stent Euphoria Following FDA Clearance of the Absorb."
Krishna Rocha-Singh, M.D., Prairie Vascular Institute, Springfield, Ill., explains advancements in device therapy for hypertension at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He was involved in the SYMPLICITY HTN-3 denervation trial and is the principal investigator for the ongoing Rox Coupler arteriovenous device trial. Watch the VIDEO “New Approaches to Denervation Therapy.”
David Kandzari, M.D., director of interventional cardiology and chief scientific officer, Piedmont Heart Institute, Atlanta, Ga., explains the impact of the EXCEL Trial at TCT 2016. Piedmont recruited the highest number of patients for the large, randomized trial found the Xience V drug-eluting stent had comparable outcomes to coronary artery bypass graft surgery. This is the first time this parity has been shown in a large trial. Read the article "Stents, Bypass Surgery Equally Safe and Effective for Many With Left Main Heart Disease."
Studies have shown transcatheter aortic valve replacement (TAVR) has an increased risk of stroke and cerebral damage due to emboli released during the procedure. Recent clinical data show the extent of this damage on MRI. Several TAVR embolic protection systems are being developed to reduce this damage. This video explains one of those systems. Read about trial data presented at TCT 2016 "Delirium Significantly Associated With Brain Lesions in Patients Post-TAVR." Read the article, “TAVR Embolic Protection Did Not Reduce Emboli Brain Lesions,” which was a second trial presented at TCT 2016.
This video, provided by Zoll, demonstrates how cardiologists can explain sudden cardiac death to patients. It is critical to educate patients who are at risk of sudden cardiac arrest (SCA), so Rahul Doshi, M.D., director of electrophysiology, associate professor of clinical medicine, Keck Medical Center of University of Southern California, explains sudden cardiac death (SCD) to his patients using a simple illustration. Visit SCDFacts.org for additional resources for you and your team to support the SCD conversation with your patients. One in five post-AMI patients have been shown to be at high risk of dying after PCI.1 The majority of mortality in AMI patients post-PCI occurs in the first three months — one out of every 10 high-risk patients die, with about 60 percent of this mortality due to SCD.[1,2]
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from high-value supplies. However, managing your critical supplies in the cath lab can be a challenge. How can you get the supply waste in your facility under control? Watch this short video to learn how an automated inventory management solution could help you reduce the waste in your hospital while improving your total cost of care. For more information visit www.cardinalhealth.com.
This video, provided by Xeltis, demonstrates the world’s first bioresorbable heart valve enabling cardiovascular restoration for pediatric patients. The Xplore-I clinical study of Xeltis bioabsorbable pulmonary heart valve, is a a multi-centered feasibility trial currently enrolling pediatric patients from 2 to 21 years of age in leading heart centers in Europe. Read the article “First Bioresorbable Heart Valves Implanted to Enable Cardiovascular Restoration.”
With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient care, there is no room in your cath lab for high-value medical device waste. An automated inventory management solution could help you find and reduce the waste hiding in your supply chain while helping to improve your total cost of care. Visit cardinalhealth.com/CIMS.
This video, provided by Shockwave Medical, demonstrates the Lithoplasty System. It uses ultrasonic waves to treatment calcified plaque in patients with peripheral artery disease (PAD). It was cleared by the U.S. FDA in September 2016. The technology is the first of its kind in interventional cardiovascular medicine. Using similar lithotripsy technology that is already in use to break up kidney stones, the balloon catheter cracks and breaks up calcium in vessel walls, without the need to over inflate the balloon, which can lead to extensive vessel damage. Read the article "FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound."
This video, provided by Respicardia, demonstrates the Remede System is a pacemaker-like implantable device. It is designed to improve cardiovascular health by restoring natural breathing during sleep in patients with central sleep apnea. In this video from The Ohio State University, William Abraham, M.D., director of the Division of Cardiovascular Medicine at The Ohio State University Wexner Medical Center, explains how the technology works and highlights one patient case involved in a recent study of the device.
Pacemakers, stents and bandages — keeping tracking of what is on hand and accurately capturing charges can be a challenge. What if you could track, manage and analyze your cath lab inventory – low cost to high value – to reveal powerful business intelligence and shine a light on new savings and revenue capture?
This video, provided by Edwards Lifesciences, demonstrates the Intuity Elite surgical aortic valve, which uses a balloon expandable skirt technology taken from the Edwards Sapien TAVR valve. This enables rapid valve deployment without the need to suture the device in place. Read about the FDA approval of the valve in August 2016.
You have bigger priorities than managing inventory. Patient safety, quality care and clinician satisfaction top the list. But automated technology can help you improve the way you purchase, control and manage your cath lab inventory, allowing you to positively support your top priorities – and your hospital’s overall performance. For more information, watch this archived webinar on inventory management in the cath lab
Interview with Patricia Dickson, LRT (CT), assistant director, diagnostic and outpatient services, Capital Cardiology Associates, Albany, N.Y., at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. She explains what technologists need to know when prepping patients and imaging during cardiac CT exams. For trends in cardiac CT, watch the VIDEO "The Future of Cardiac CT in the Next Decade."
Interview with Claudio Smuclovisky, M.D., FACC, FSCCT, director of South Florida Imaging Cardiovascular Institute, Holy Cross Hospital, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. Smuclovisky explains what imaging departments need to know about advances in CT systems when purchasing the newest generation of CT scanners. He explains there is more to scanners than slices, offering information beyond the hype over 64-, 128-, 256-, 320-, and 640-slice CT scanners. For more information, read "Costs vs. Benefits: Comparing 64-Slice to 256, 320-Slice CT."
An interview with Jonathan Leipsic, M.D., FSCCT, chairman of the department of radiology, St. Paul’s Hospital, Vancouver, Canada, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Leipsic is heavily involved with the procedural planning and anatomical assessments for TAVR and clinical trials for new transcatheter mitral valves and annulus repairs.
DAIC/ITN editor Dave Fornell shows some of the most innovative new cardiac CT and angiography technologies from sessions and the expo floor at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. Read the article "Advances in Cardiac CT Technology."
An interview with Matthew Budoff, M.D., FACC, director of cardiac CT, Harbor-UCLA Medical Center, Torrance, Calif., at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Budoff explains how CT calcium scoring can be used to assess patients risk for coronary disease and if they should be on statin therapy. Read the 2017 article "Screening for Heart Disease May Lead to Prevention, Better Treatments."
An interview with Leslee Shaw, Ph.D, FACC, FASNC, FAHA, co-director of the Emory Clinical Cardiovascular Research Institute at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Read the related article “Advances in Cardiac CT Technology."
An interview with Ricardo Cury, M.D., director of cardiac imaging, Miami Cardiac and Vascular Institute, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Cury who was instrumental in the development of the new CAD-RADS scoring system, which similar to BI-RADS used for breast imaging or LUNG-RADS use for assessment of lung diseases, is used to standardize the radiological assessment of coronary artery disease. For more information, read "Multi-Society Group Releases CAD-RADS for Standardized Coronary CT Angiography Reporting."
DAIC/ITN editor Dave Fornell shares some of the innovative new technologies on the show floor of the American Society of Echocardiography (ASE) 2016 annual meeting. Read the article "Top Trends in Cardiac Ultrasound."
Interview with Stephen Little, M.D., medical director of the Valve Clinic at the Houston Methodist DeBakey Heart and Vascular Center, at the American Society of Echocardiography (ASE) 2016 annual meeting. He explains the technologies his center is using to aid transcatheter structural heart procedure navigation, including TAVR, transcatheter mitral valve replacement (TMVR), LAA occlusion, and septal defect occlusions. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the VIDEO "What is Required for Interventional Echo - Discussion With Rebecca Hahn."
Interview with Federico Asch, M.D., FACC, FASE, associate director of the echocardiography core lab at Medstar Health Research Institute and assistant professor of medicine (cardiology) at Georgetown University, at the American Society of Echocardiography (ASE) 2016 annual meeting. Asch discusses the technology used for cardio-oncology cardiotoxcity assessments and how to set up these types of collaborative programs between oncology and cardiology. For more information, read the article Assessing Cardiotoxicity Due to Cancer Therapy.
Interview with MD Buyline clinical analysts Jon Brubaker and Sabrina Newell at the American Society of Echocardiography (ASE) 2016 annual meeting. They highlighted trends they have seen in cardiac strain imaging, 3-D echo, bubble contrast, interventional echo, structural heart, and point-of-care ultrasound. Read the article on trends from Brubaker and Newell - "Top Trends in Cardiac Ultrasound at ASE 2016."
Interview with Rebecca Hahn, M.D., FASE, Columbia University Medical Center, New York, at the American Society of Echocardiography (ASE) 2016 meeting. She is an expert in the new subspecialty of interventional echo and discussed considerations for hospitals thinking of creating interventional echo programs to help guide complex transcatheter structural heart procedures in the cath lab or hybrid OR. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the related VIDEO "Transcatheter Structural Heart Procedure Navigation Technology Advances."