This year’s 16th annual American Society of Nuclear Cardiology (ASNC) scientific session, which took place last week in Denver, highlighted where the future of nuclear cardiology is headed, and what steps are necessary to make it flourish. While some presentations focused on how nuclear cardiology can stay afloat during the ambiguous era of healthcare reform, others focused on the need to eliminate inappropriate testing as a means to reduce radiation exposure, often the Achilles heel of imaging exams.
While exposing patients to radiation is an obvious concern to technicians and others, the remedy may start with proper patient selection, offered George A. Beller, MD, a cardiologist at the University of Virginia Health System in Charlottesville. In fact, Beller said while the accuracy of the imaging exam is important, reducing radiation dose will be key. Additionally, he said appropriately selecting patients for nuclear imaging will be imperative to decreasing radiation exposure risk.
As far as reducing dose goes, Robert C. Hendel, MD, of the University of Miami Miller School of Medicine in Miami, said the best tactic will be to eliminate inappropriate imaging, "no imaging, emits no radiation." Hendel also said that eliminating “serial testing” would prevent patients from being exposed to even larger doses of radiation, which can oftentimes be prevented.
While fears of radiation seemed to take center stage at the meeting, weighing whether coronary artery calcium ( CAC) screening should be a component to nuclear imaging to add to the detection and management of coronary artery disease. Tim M. Bateman, MD, of Saint Luke’s Health System in Kansas City, offered that while CAC screening can change diagnoses, it is still unknown as to whether it will impact outcomes.
Additionally, Bateman offered that adding CAC screening to SPECT exams can help with patient management. In fact, a previous study showed that knowing a patient’s CAC score improved the proper administration of therapy, including statin and aspirin use.
While issues of radiation, reimbursement and CAC screening were repetitive at the meeting, additional topics included whether MR or CT will be the wave of the future and which is better, exercise only or pharmacological agents for stress imaging. ASNC was a hot bed for imaging experts to come together to give their opinions as a means to change the future of imaging for the better. As healthcare reform is here and experts work to reduce costs, they will also work to reform the field to gain better outcomes.