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Saturday, December 13, 2008

Cardiac imaging definitions

Cardiac imaging is an integral part of the evaluation and management of patients with known or suspected heart disease. These techniques offer insight into morphologic features and physiologic functioning of the myocardium, valves, pericardium, coronary arteries, and great vessels. Substantial advances in technology have occurred within the past decade, advancing clinical applications and enhancing diagnostic accuracy.

Many options for imaging the heart and adjacent structures are available such as, echocardiography, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), positron emission tomography (PET), cardiac magnetic resonance (CMR), cardiac computed tomography (CCT), invasive coronary angiography (ICA), and left ventriculography (LVG). Major specialty societies, such as the ACC, the AHA, the Radiological Society of North American (RSNA), and the American College of Radiology (ACR) have demonstrated leadership in promoting research and written guidelines and practice standards for the performance of cardiac imaging. In many cases, each modality has developed rather independently and has strong advocacy by dedicated clinicians/researchers and their own subspecialty societies, including the American Society of Nuclear Cardiology (ASNC), the American Society of Echocardiography (ASE), the Society for Atherosclerosis Imaging and Prevention (SAIP), the Society for Cardiovascular Computed Tomography (SCCT), the Society for Cardiovascular Magnetic Resonance (SCMR), the Society for Cardiovascular Angiography and Interventions (SCAI), the Society of Interventional Radiology (SIR), the North American Society for Cardiovascular Imaging (NASCI), and the Heart Rhythm Society (HRS).

Cardiac imaging is included in patient decision-making and is often referenced in guidelines and other data standards. However, differing definitions abound, leading to misunderstanding and confusion. Furthermore, structured reporting is becoming commonplace and imaging data fields are increasingly being used within registries and clinical databases. The ACC has led a multisocietal effort that culminated in the development of a document that recommends the use of structured reporting for cardiovascular imaging as an essential component of improved cardiovascular health care (1); that article is being published simultaneously with these data standards. These two writing efforts were coordinated with each other and underscore the importance for capturing and reporting clear, consistent and complete information for patients undergoing cardiovascular imaging./.../

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