Societies must adapt to the rise of multimodality cardiac imaging
Cardiac imaging has evolved from a collection of siloed specialties into a multimodality discipline, a shift that is reshaping how imagers train, practice and engage with professional societies, according to American Society of Echocardiography (ASE) President David H. Wiener, MD.
In his keynote at the ASE 2025 conference, Wiener said the field has moved far beyond the era when most cardiologists trained in a single imaging modality.
“When I was training, people would come out as unimodality images, which I am, and some would come out with some training in another modality. The people we're attracting now onto the faculty and as leaders, and in many non-academic settings, are trained in and they want to practice multimodality imaging,” Wiener said.
This trend reflects the clinical reality of contemporary cardiovascular care; complex diseases often require multiple imaging tools.
“When you think about diseases like hypertrophic cardiomyopathy, sarcoidosis amyloidosis and even valve disease, echocardiography is the gateway. It's the way to follow people. It's non-invasive, it's quick. But sometimes you need a cardiac MR exam to quantitate valve disease," Wiener said.
As a result, Wiener said imaging societies need to rethink how they support physicians whose careers span echocardiography, cardiac CT, nuclear cardiology and cardiac MRI.
“We want to figure out a way that we can make multimodality training possible, multimodality certification and maintenance of certification in a contemporary manner possible, less expensive and more aligned with the way that people learn today,” he said. “We also have to demonstrate our value fiscally.”
Cost and time burdens are among the most common complaints Wiener hears from multimodality imagers. One complaint heard across the board is that their training pathways, maintenance of certification and societal memberships in multiple societies can cost thousands and thousands of dollars per year. Traveling to multiple national meetings also compounds the problem, both financially and logistically, he added.
To address this, Wiener said societies are exploring coordinated approaches, including shared maintenance of certification programs and co-located meetings.
Wiener pointed to heart team meetings at hospitals as a model for how imaging societies might collaborate. At his own facility, for example, he said surgeons, interventional cardiologists and multiple imagers show up every Tuesday morning to discuss patient care.
Looking ahead, Wiener said progress will be incremental as it will take time to coordinate meetings and make other changes. Work was started on this prior to the COVID-19 pandemic, he added, but then it was disrupted when so many things had to be stopped or put on hold.
“Society meetings are planned many years in advance, so it's going to take more than a couple of years,” he said.
Still, he sees momentum building, citing Europe’s decision to unify imaging meetings into a single cardiovascular imaging conference.
“I don't know if that's the right model in the United States, but that's where something akin to that is where I think things will be going," he added.
For ASE and other imaging societies, Wiener said the challenge will be balancing tradition with the needs of a new generation of multimodality imagers—while keeping patient-centered care at the core of those efforts.
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: [email protected]