Cardiac MRI

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Medicare's decision against a national coverage determination for coronary CT angiography is not the end of conflict for the modality. It is just the beginning. The next battle involves fulfilling the promises the multisociety alliance made to assure the Centers for Medicare and Medicaid Services that its acceptance of coronary CT will not turn into a multibillion-dollar debacle.

Calcium deposits in coronary arteries provide a strong predictor for incidence of heart attack and cardiac disease, and detecting such deposits via CT scanning can help promote overall cardiac health in racially and ethnically diverse populations, according to a new study in March 28 issue of The New England Journal of Medicine.

The enhanced spatial resolution and speed afforded by 64-slice CT scanning could enable the accurate assessment of right ventricular function in patients with cardiovascular disease, according to researchers in China and the U.S.

Patients’ risk of developing a radiation-induced cancer is actually far lower than reports suggest, ECR delegates concerned about the level of radiation associated with cardiac CT were told in Vienna.

CMS stirs up hornet’s nest with threat to disallowan option for local Medicare coverage decisions and prohibit cardiac CT angiography for all but trial patients

tudies of chest pain patients with conventional 64-slice and dual-source CT add to a growing base of evidence suggesting that CT is well suited to rule out acute coronary syndrome in the emergency room and to identify coronary artery in-stent restenosis. An initial study of 256-slice CT presented at the RSNA meeting was encouraging, but the specter of high radiation exposure—especially exams covering the entire chest—challenged researchers to find better ways to reduce dose.

The American Society of Echocardiography has issued a new consensus statement for interpreting and responding to results of carotid artery ultrasound. The guidelines set carotid artery wall thickness values greater than the 75th percentile as the threshold for aggressive treatment.

he explosive growth of Medicare outpatient imaging from 2000 to 2005 explains why federal regulators have singled out radiologists for restraints. Medicare payments for outpatient medical imaging jumped 93% during that period, from $6 billion to more than $11 billion.

Studies of chest pain patients with conventional 64-slice and dual-source CT add to a growing base of evidence suggesting that CT is well suited to rule out acute coronary syndrome in the emergency room and to identify coronary artery in-stent restenosis. An initial study of 256-slice CT presented at the RSNA meeting was encouraging, but the specter of high radiation exposure-especially exams covering the entire chest-challenged researchers to find better ways to reduce dose.

Investigators begin recruiting the first of 7300 volunteers this month for a massive clinical trial to determine if a combination of blood tests, body measurements, and imaging exam can outperform the Framingham tests for assessing older adults who carry an intermediate risk of a major cardiovascular event, including myocardial infarction and stroke.

Increasing efforts to screen and diagnose coronary artery disease have used imaging modalities such as catheter angiography, ultrasound, and MRI. Electron-beam CT was, for a long time, the only CT system able to image the coronary arteries without motion artifacts. But multislice CT has advanced rapidly over the last decade, and state-of-the-art 64-slice and dual-source CT now offer high-quality imaging of the coronary arteries, myocardium, and valves, providing morphological and even functional information.

Hospitalists given focused training for conducting cardiac exams with hand-carried ultrasound systems still could not match echocardiography technicians at acquiring images, though they came closer at measurement and interpretation. Hand-carried ultrasound devices are growing in popularity, but training methods for noncardiologists have not been well defined.