Cardiac CT practitioners create two new societies

Maintaining order in the rapidly changing, sometimes contentious development of cardiac CT imaging may have become easier. Last weekend, two independent groups met in two U.S. cities to establish two separate professional societies geared toward promoting the clinical use of cardiac CT angiography.

In Chicago, nearly 100 people gathered under the umbrella of the American Society for Cardiac Computed Tomography, or ASCCT (it may drop "American" in favor of a more international flavor). In Atlanta, about 25 people met to form the Society for Cardiac Computed Tomography (SCCT).

The membership philosophy of both groups makes each available to all physicians, but cardiologists represented the majority of physicians at both meetings. It also should be understood that the "cardiac" in the title of both societies is short for "cardiovascular," according to sources from both sides.

"I'm not sure why we need two more societies," said Dr. Jeffrey C. Weinreb, chair of the American College of Radiology commission on quality and safety. "Whenever there is anything new and money at stake, it seems that people form a new society because they want to be in charge."

It's not clear why the two groups cannot merge into one. Some from ASSCT have said the SCCT is catering too much to cardiologists. Some from SCCT have said the preponderance of private practitioners in the ASCCT is a weakness in terms of advocacy and education. But both sides have said they hope to eventually unite into one society.

Participants at the ASCCT meeting agreed that the mission of the society is to advance the role of CT in cardiac and vascular practice. They spent a lot of time hammering out consensus on topics such as education, training, and quality assurance.

"One reason for standardizing protocols and establishing mechanisms for quality assurance is to avoid a repeat of the 'Wild West' mentality that accompanied the early days of calcium scoring and lung cancer screening," said Dr. U. Joseph Schoepf, director of CT research and development at the Medical University of South Carolina, and a radiologist who attended the ASCCT meeting.

Participants determined that a training program should consist of a week-long study that includes a certain number of cases and some didactic programs at an approved training site. Another avenue of instruction could be over the Internet, where the cases are sent to a proctor for overread, said Tim Attebery, CEO of South Carolina Heart Center in Columbia, a key figure in ASCCT's formation.

Regarding residency training, the ASCCT also will strive to be an advisory group to the American College of Cardiology and the American Board of Radiology as they design curricula for their board programs.

Representatives of the ACC and the American Society of Nuclear Cardiology at the meeting expressed interest in collaborating with the ASCCT. The new group could develop training, competency, billing, and coding standards that the two larger societies can embrace, Attebery said.

TeraRecon and Siemens provided unsolicited educational grants to help underwrite the meeting.

The SCCT meeting did not go into as much detail, according to Zahi Fayad, Ph.D., director of cardiovascular imaging at Mount Sinai School of Medicine in New York City. Fayad was a prime mover in that group's formation. The Atlanta meeting was primarily a business meeting that including representatives in the emerging field of noninvasive cardiology, as well as participants from GE, Philips, and Siemens.

One thing the SCCT did produce was a vision statement:

"The Society of Cardiac Computed tomography will be the recognized representative and advocate for physicians, scientists and technologists who work in the field of cardiac computed tomography. It will nationally and internationally be seen as the principal independent organization committed to the further development of cardiac computed tomography through education, training, accreditation, advocacy, quality control and research."

The SCCT will meet during the March ACC meeting in Orlando to elect officers and board members. Convening at the ACC meeting in no way represents a special attachment to cardiologists, Fayad said.

"It was merely the timeliest meeting for us to get together," he said.

Collaborations among the larger societies have produced mixed results. The ACC worked with ACR, the Society of Interventional Radiology, and the North American Society for Cardiac Imaging (NASCI) in 2004 to help develop cardiac imaging competency guidelines. That process slowed when the ACC began to look at the possibility of expanding its reach to the entire cardiovasculature system, according to Dr. Robert Steiner, director of thoracic and cardiac radiology at Temple University.

The ACR, meanwhile, is formulating a policy statement on cardiac CT, according to Dr. Arthur Stillman, a member of the ACR policy writing committee. Stillman, a cardiac radiologist at the Cleveland Clinic, represented NASCI at the SCCT meeting.

"There is a lot of high anxiety right now among cardiologists and radiologists. The key here is to not threaten anybody, but at the same time not to concede the whole field," Stillman said.

For more information from the Diagnostic Imaging archives:

ACR pursues designated physician imager legislation

CTA builds reputation in peripheral disease

Radiologists move to protect MR and CT turf

Self-referral course draws stealth response from cardiologists