Leading-edge imaging for cardiology will be the featured technology at an inaugural conference, opening tomorrow in Milwaukee, sponsored by the Wisconsin Heart Hospital.
"CT [computed tomography] Angiography for Cardiologists" is the name of the two-day conference, and this imaging application "is taking off like a house afire" in cardiology, said Sam Wann, MD, carving out a hurried few minutes from his conference preparations to talk to Diagnostics & Imaging Week.
Wann is chairman of the Wisconsin Heart Hospital's Department of Cardiovascular Medicine and also currently active in both the American College of Cardiology (ACC) and the American Society of Nuclear Cardiology (both Bethesda, Maryland), which are co-sponsoring the first-ever event.
"CT Angiography for Cardiologists" also is the first conference sponsored by the hospital open only somewhat more than a year which is a smaller facility focused entirely on cardiovascular diagnosis and treatment.
The bottom line, Wann told D&IW, is that CT angiography (CTA) in the hands of cardiologists, not just radiologists, ultimately will provide cath lab-type imaging and information about the cardiovascular system but without cath lab-type invasiveness.
CTA uses X-rays to visualize blood flow in arterial vessels throughout the body. Critical to this technique is the combination of X-ray images with computerized analysis of these images.
"The promise is to do coronary angiography, hopefully, with intravenous injection and a single breathhold of 10 seconds or less using CT and providing diagnostic-quality images," Wann said. "We're not there yet," he added as a qualifier. "But we're close, and people are very, very excited about it."
CTA has made more advancements in Europe, primarily Germany and the Netherlands, Wann noted, while adding that the U.S. "will catch up," with educational conferences such as the current effort.
Conference sponsors are expecting 450 attendees. And, importantly, the critical core of vendors at the conference will be GE Healthcare (Waukesha, Wisconsin), Philips Medical Systems (Andover, Massachusetts), Siemens Medical Solutions (Malvern, Pennsylvania/Erlangen, Germany) and Toshiba Medical Systems (Tustin, California/Tochigi, Japan), manufacturers of the CT machines, plus various other workstation and imaging agent providers.
With independent rather than vendor-type sponsorship, the event will be an "ecumenical, not a proprietary kind of presentation," Wann emphasized. It will include a number of breakout sessions featuring "experts, with a variety of different equipment, to show [attendees] how they use them in clinical practice the advantages, the pitfalls," he said.
The conference additionally will feature a patient CT procedure via live television feed to conference attendees on Saturday, from 12:45-1:45 p.m.
A faculty of 15 cardiologists, described by the organizers as "all leaders in their field at major academic and private practice institutions" will be making the various presentations.
Among the CT scan pioneers offering their expertise will be Michael Poon, MD, chief of cardiology at Cabrini Medical Center (New York). Poon is billed as a leader in the effort to get the Centers for Medicare & Medicaid Services (CMS; Baltimore) and private insurance companies to pay for the procedures.
"I don't think there's any question that [CMS] should reimburse this," Poon said. "[CT angiography] has really unique clinical utilities."
He added: "Traditionally, we do a lot of invasive diagnostic coronary angiograms that are normal. You might ask why we would do an invasive test that has risks for the patient one in 1,000 for a heart attack or a stroke. Until recently, we haven't had a non-invasive option. The invasive test costs the payer about $10,000 and in one recent case, where the patient had to be kept in the hospital for two days before having an angiogram that was normal, she got a bill for $25,000.
"In that same scenario," he explained, "the patient could be scanned with the CT and if it comes out normal, you send the patient home the same day. The cost would be about $800."
Another conference presenter is Joao AC Lima, MD, associate professor of medicine and director of cardiovascular imaging at Johns Hopkins Hospital (Baltimore).
"This conference is the first major meeting after the March ACC meeting in Orlando and is very important because it comes at a time when cardiologists are quickly realizing the power of multi-detector CT angiography to look at coronary arteries and study them," Lima said.
"We realize that this is a powerful tool that could be used effectively for patients with heart disease. For example, it could help us gauge which patients should be taking the statin medications and whether this therapy is working to prevent cholesterol buildup in the arteries. If the technology fulfills its promise, I consider CT Angiography of the same magnitude as the introduction of invasive angiography and ultrasound technologies in the 1970s, which transformed the practice of cardiovascular medicine."
Open only since January 2004, the Wisconsin Heart Hospital is focused, Wann said, on leading the way in encouraging "all hospitals in our system [Covenant Healthcare] and in others to use CT angiography."
Wann noted that the hospital currently uses a 16-slice CT machine but will soon be upgrading to the more powerful 64-slice machine.
"We're very happy to have the level of cardiac care rise in our community and we'd like to help do that," he said. "As a result of this conference, I hope that cardiologists will learn, take this information home and start doing it on their own CT machines. It is a state-of-the-art machine, but it's not one that other hospitals couldn't buy."