Videos | Coronavirus (COVID-19) | March 20, 2020

VIDEO: Cancelling Non-essential Cardiac Procedures During the COVID-19 Outbreak

An interview with Ehtisham Mahmud, M.D., FSCAI, chief, Division of Cardiovascular Medicine, executive director of medicine, Cardiovascular Institute, director of  interventional cardiology and cardiac cath lab at UC San Diego Medical Center, and president of the Society for Cardiovascular Angiography and Interventions (SCAI). He explains the how cardiology departments in the U.S. are now postponing cardiovascular procedures due to novel coronavirus (COVID-19, SARS-CoV-2) containment efforts and new guidelines from Medicare calling for delay of all elective procedures in the country. 

Mahmud explains how patients are being prioritized, with acute myocardial infarction patients or others with acute, life-threatening conditions, or at high risk for a near term hospital admission, will still receive cardiac catheterizations, cardiovascular surgery or structural heart procedures for MitraClip and transcatheter aortic replacement (TAVR) under certain circumstances. All other procedures are being postponed until further notice based in the spread and infection rates of COVID-19. He said most hospitals, including his own, are moving to telehealth visits via phone or online to continue clinic work with patients, including those with chronic conditions such as heart failure.

The Centers for Medicare and Medicaid Services (CMS) announced March 18, 2020, that all elective surgeries, and non-essential medical, surgical and dental procedures should be delayed during the coronavirus outbreak. This move is three-fold. 
   1. It is to help with containment efforts by reducing patient and family travel to hospitals, which are at the center of the COVID-19 outbreak. 
   2. Delaying procedures will help preserve and inventory of personal protective equipment (PPE), hospital beds and ventilators and other medical supplies. 
   3. With the start of social distancing and the shut down of all large gatherings, this has severely impacted blood drives and other blood donations, so the nation's blood banks have severely limited supplies.

“The reality is clear and the stakes are high — we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.

This will not only preserve equipment but also free up the healthcare workforce to care for the patients who are most in need. Additionally, as states and the nation as a whole work toward limiting the spread of COVID-19, healthcare providers should encourage patients to remain home, unless there is an emergency, to protect others while also limiting their exposure to the virus. 

Read Mahmud's SCAI President's letter The Evolving Pandemic of COVID-19 and Interventional Cardiology

 

Related Cardiology Related COVID-19 Content:

ACC COVID-19 recommendations for the cardiovascular care team

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

The Cardiac Implications of Novel Coronavirus

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

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

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

 

Additional COVID-19 Resources for Clinicians:

   ACC COVID-19 Hub page   

   Johns Hopkins Coronavirus Resource Center with inteavtive map of cases in U.S. and worldwide 

   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
 


 

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American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

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Read more in the article — First International Chest Pain Diagnosis Guidelines Released

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American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

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Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

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Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

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Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

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American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

Nuclear Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

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Artificial Intelligence | January 13, 2022

Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response. 

Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

Find more AI news

Find more RSNA news and video

 

 

Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

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Cardiac Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

Nuclear Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

Find more nuclear imaging technology news

 

Artificial Intelligence | January 13, 2022

Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response. 

Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

Find more AI news

Find more RSNA news and video

 

 

Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

VIDEO: Cardiac MRI Assessment of Non-ischemic Myocardial Inflammation Caused by COVID-19 Vaccinations — Interview with Kate Hanneman, M.D.

Cardiac MRI of Myocarditis After COVID-19 Vaccination in Adolescents

Large International Study Reveals Spectrum of COVID-19 Brain Complications - RSNA 2021 late-breaker

COVID-19 During Pregnancy Doesn’t Harm Baby’s Brain

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

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Cardiac Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

Nuclear Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

Find more nuclear imaging technology news

 

Artificial Intelligence | January 13, 2022

Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response. 

Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

Find more AI news

Find more RSNA news and video

 

 

Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

VIDEO: Cardiac MRI Assessment of Non-ischemic Myocardial Inflammation Caused by COVID-19 Vaccinations — Interview with Kate Hanneman, M.D.

Cardiac MRI of Myocarditis After COVID-19 Vaccination in Adolescents

Large International Study Reveals Spectrum of COVID-19 Brain Complications - RSNA 2021 late-breaker

COVID-19 During Pregnancy Doesn’t Harm Baby’s Brain

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

EP Lab View all 82 items

Cardiac Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

Nuclear Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

Find more nuclear imaging technology news

 

Artificial Intelligence | January 13, 2022

Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response. 

Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

Find more AI news

Find more RSNA news and video

 

 

Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

VIDEO: Cardiac MRI Assessment of Non-ischemic Myocardial Inflammation Caused by COVID-19 Vaccinations — Interview with Kate Hanneman, M.D.

Cardiac MRI of Myocarditis After COVID-19 Vaccination in Adolescents

Large International Study Reveals Spectrum of COVID-19 Brain Complications - RSNA 2021 late-breaker

COVID-19 During Pregnancy Doesn’t Harm Baby’s Brain

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

Information Technology View all 167 items

Cardiac Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, explains why the society did not endorse the first-ever U.S. or international guideline for the evaluation and diagnosis of patients with acute or stable chest pain.

Nuclear myocardial perfusion imaging (MPI) has been a gold-standard for evaluation of coronary disease in patients for years, and it is included in the new guidelines. However, computed tomography angiography (CTA) has seen immense growth over the past decade and gained a prominent position in the guidelines as a front line imaging modality. This is due to nearly all hospital emergency rooms now having access to CT systems capable of performing immediate cardiac exams. CT has been seen mainly as an anatomical imaging test, but it also can be used for myocardial perfusion imaging using iodine contrast. While CT has had limits with its ability to image through heavily calcified vessels or stents, that is changing with new CT technologies now coming into service.

One new CT technology that is prominently included I the new chest pain guidelines is CT fractional flow reserve (FFR-CT) imaging.  This uses a computational fluid dynamics algorithm to analyze a patient's CTA. It sends back a report and an interactive 3D reconstruction of all the coronary vessels that shows a color coded drop in FFR ratios, which is a measure of blood flow. Past a certain threshold, the reduced flow needs to be treated with revascularization. Lower level blockages can be treated with drug therapies. FFR-CT is widely expected in the coming years to become a gate keeper for invasive diagnostic angiograms. The hope is it will eliminate the need for the majority of cath lab angiogram exams and only send patients to the lab that need a stent or angioplasty. 

However, the ASNC had major issues with FFR-CT being included in the chest pain guidelines. Its board members argued there is need for more evidence and there should have been more information contraindications for its use, which was included on other imaging modalities in the guidelines. They also argued access to the technology has been very limited. Calnon explains more detail in the video on why this was a sticking point and caused the ASNC to not endorse the guidelines.

Read more in the article — First International Chest Pain Diagnosis Guidelines Released

Nuclear Imaging | February 01, 2022

American Society of Nuclear Cardiology (ASNC) President Dennis Calnon, M.D., MASNC, FASE, FSCCT, director of cardiac imaging for McConnell Heart Hospital at Riverside Methodist Hospital, and director of nuclear imaging for Ohio Health Heart and Vascular Physicians in Columbus, offers a concise overview of new technologies that are enhancing cardiac nuclear imaging. He also explains some of the new developments and uses for PET and SPECT imaging technology.

Find more nuclear imaging technology news

 

Artificial Intelligence | January 13, 2022

Here are two examples of artificial intelligence (AI) driven pulmonary embolism (PE) response team apps featured by vendors Aidoc and Viz.AI at the 2021 Radiological Society of North America (RSNA) 2021 meeting.

The AI scans computed tomography (CT) image datasets as they came off the imaging system and looked for evidence of PE. If detected by the algorithm, it immediately sends an alert to the stroke care team members via smartphone messaging. This is done before the images are even loaded into the PACS. The radiologist on the team can use a link on the app to open the CT dataset and has basic tools for scrolling, windowing and leveling to determine if there is a PE and the severity. The team can then use the app to send messages, access patient information, imaging and reports. This enabled them all to be on the same page and can communicate quickly via mobile devices, rather than being required to use dedicated workstations in the hospital. 

Both vendors showed similar apps for stroke at RSNA 2019. That idea for rapid alerts, diagnosis and communications for acute care teams has now expanded to PE and also for aortic dissection and abdominal aortic aneurysms (AAA). AI.Viz and Aidoc are looking at expanding this type of technology for other acute care team rolls, including heart failure response. 

Read more about this technology in the article AI Can Facilitate Automated Activation of Pulmonary Embolism Response Teams.

Find more AI news

Find more RSNA news and video

 

 

Coronavirus (COVID-19) | December 14, 2021

Jean Jeudy, M.D., professor of radiology and vice chair of informatics at the University of Maryland School of Medicine, presented a late-breaking study at the 2021 Radiological Society of North America (RSNA) meeting on COVID-19 linked myocarditis in college athletes. 

A small but significant percentage of college athletes with COVID-19 develop myocarditis, a potentially dangerous inflammation of the heart muscle, that can only be seen on cardiac MRI, according to the study Jeudy presented. Myocarditis, which typically occurs as a result of a bacterial or viral infection, can affect the heart’s rhythm and ability to pump and often leaves behind lasting damage in the form of scarring to the heart muscle. It has been linked to as many as 20% of sudden deaths in young athletes. The COVID-19 pandemic raised concerns over an increased incidence of the condition in student-athletes.

For the new study, clinicians at schools in the highly competitive Big Ten athletic conference collaborated to collect data on the frequency of myocarditis in student-athletes recovering from COVID-19 infection. Conference officials had required all athletes who had COVID-19 to get a series of cardiac tests before returning to play, providing a unique opportunity for researchers to collect data on the athletes’ cardiac status.

Jeudy serves as the cardiac MRI core leader for the Big Ten Cardiac Registry. This registry oversaw the collection of all the data from the individual schools of the Big Ten conference. He reviewed the results of 1,597 cardiac MRI exams collected at the 13 participating schools. 

Thirty-seven of the athletes, or 2.3%, were diagnosed with COVID-19 myocarditis, a percentage on par with the incidence of myocarditis in the general population. However, an alarmingly high proportion of the myocarditis cases were found in athletes with no clinical symptoms. Twenty of the patients with COVID-19 myocarditis (54%) had neither cardiac symptoms nor cardiac testing abnormalities. Only cardiac MRI identified the problem.

Read more details in the article COVID-19 Linked to Heart Inflammation in College Athletes.

Related COVID-19 Imaging and Myocarditis Content:

Overview of Myocarditis Cases Caused by the COVID-19 Vaccine

COVID-19 Linked to Heart Inflammation in College Athletes — RSNA 2021 late-breaker

VIDEO: Cardiac MRI Assessment of Non-ischemic Myocardial Inflammation Caused by COVID-19 Vaccinations — Interview with Kate Hanneman, M.D.

Cardiac MRI of Myocarditis After COVID-19 Vaccination in Adolescents

Large International Study Reveals Spectrum of COVID-19 Brain Complications - RSNA 2021 late-breaker

COVID-19 During Pregnancy Doesn’t Harm Baby’s Brain

VIDEO: Large Radiology Study Reveals Spectrum of COVID-19 Brain Complications — Interview with Scott Faro, M.D.

FDA Adds Myocarditis Warning to COVID mRNA Vaccine Clinician Fact Sheets

Small Number of Patients Have Myocarditis-like Illness After COVID-19 Vaccination

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