New 2024 American Society of Nuclear Cardiology (ASNC) President Lawrence Phillips, MD, set forth ambitious goals aimed at modernizing nuclear cardiology labs and extending diagnostic capabilities beyond traditional perfusion assessments.
Phillips, director of nuclear cardiology and medical director for outpatient cardiology at NYU Langone Health, said these priorities are based on the fact that many nuclear cardiology labs are still using imaging systems that are 20 years old and labs need to embrace technological advancements. While nuclear studies have declined over the past decade, nuclear cardiology is now seeing growth from new types of exams, including scans for cardiac amyloidosis, inflammation and sarcoidosis.
Nuclear cardiology needs to modernize
Upgrading imaging systems and software to improve image quality and decrease radiation dose has become a continuing theme with ASNC leadership calls to action in recent years.
"Modernization of the lab may look different for different people ... for some people, modernization of the lab is going to be a protocol change, it's going to be implementing stress-first imaging so that you can reduce the radiation exposure and improve patient satisfaction and at the same time have the same quality imaging," Phillips explained.
Other changes might be the implementation of stress-first imaging or multi-position imaging to help decrease false positives, or upgrading software to enable virtual SPECT attenuation correction and better image reconstruction. But Phillips said hardware upgrades to digital detector technology and PET imaging systems are the biggest push for modernization.
PET enables higher quality imaging and more detailed measurements
"We're really pushing for people to have more state-of-the-art cameras, to improve quality, reproducibility, to improve confidence in the technique and improving patient outcomes. And this could be through a new SPECT camera, and also the movement towards increased utilization of cardiac PET, which we're seeing and we're looking to amplify that role going into the future," Phillips explained.
For a lot of programs, he said the transition to PET is going to be important because it can be used for higher risk patients, and patients who need that better sensitivity for diagnosis. PET enables the addition of myocardial blood flow quantification, which Phillips said will add a tremendous amount of diagnostic and prognostic information to the test. PET will also allow expansion in other areas besides just perfusion, including viability and inflammation assessments.
ASNC is already seeing an uptick in PET programs.
"We are seeing it and we're seeing the discussions occur not just within our walls of of ASNC, but outside in health systems coming and asking for help in setting up their programs," Phillips explained.
To meet growing demand and to encourage PET adoption, ASNC has sponsored a series of live and on-live training sessions.
ASNC focusing on educational opportunities in nuclear cardiology
Phillips advocates for a collaborative approach, describing nuclear cardiology as a "team sport." He emphasizes the importance of education, quality improvement and unlocking the full potential of the field, especially in newer disease states. The ASNC president's game plan in 2024 is to prepare for the future of nuclear imaging with upgrading reporting standards, expanding quality improvement activities and providing innovative educational opportunities. He said ASNC is positioned to be the sponsor, coach and teammate for the nuclear cardiology community.
A significant initiative for 2024 is the expansion of hands-on training programs. Recognizing the evolving landscape of nuclear cardiology—with its growing role in diagnosing coronary artery disease, microvascular disease, amyloid imaging, sarcoid imaging and infection imaging—he said ASNC is committed to providing practical training opportunities. This initiative targets both trainees and practicing physicians, allowing them to expand their expertise in various disease states.
"For example, we've seen a tremendous growth in amyloid imaging taking place within nuclear cardiology, and we want to make sure as we see that continued growth. We are providing the full spectrum of resources for the nuclear cardiologists to learn new techniques as well as learn how to perform high-quality imaging within these techniques," Philips explained.
ASNC offers live as well as on-demand courses and case compendiums for people to see how image interpretation for different modalities and different disease states takes place.
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