VIDEO: Office-based cardiac CT and FFR-CT offer a new business model
Evans Pappas, MD, chair of the Department of Cardiology, and Sujith Kalathiveetil, MD, FACC, director of cardiac imaging at Duly Health and Care in suburban Chicago, explain the shift toward office-based cardiac CT evaluations and the role of FFR-CT.
Duly recently opened a new cardiac evaluation center in suburban Lisle, Illinois, to offer an out-patient office setting to check patients. However, this goes beyond standard check ups to including labs, ECG, stress echo and advanced cardiac computed tomography (CT) being performed in the office. All patients who are scanned and have at least a 30% blockage in a coronary artery are also evaluated with fractional flow reserve CT (FFR-CT). This offers physiologic information and serves as non-invasive version of diagnostic angiogram to assess the severity of flow limitation by a blocked coronary artery. This can help guide if the patients needs to be treated with medication, or revascularized.
The business model is designed to offer referring physicians in the Duly health system an alternative to sending patients to hospitals for full evaluations. Cardiac CT and FFR-CT were included as front-line tests in 2021 chest pain evaluation guidelines.
The clinic installed a GE/Arineta CardioGraph dedicated CT scanner optimized for cardiac scanning, but small enough to fit into an office setting. This system was built for this type of in-office clinical setting to expand the use of cardiac CT beyond hospitals.
The HeartFlow FFR-CT assessments use advanced computational fluid dynamics assessments of blood flow in the coronary arteries in the CT scan to determine the patient's FFR. This is a noninvasive alternative to using invasive pressure wires in a cath lab that are inserted into the arteries to assess hemodynamic pressure readings.
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com