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Bullock-Palmer RP, Flores Rosario K, Douglas PS, Hahn RT, Lang RM, Chareonthaitawee P, Srichai MB, Ordovas KG, Baldassarre LA, Burroughs MS, Henderson CS, Woodard PK, Pressoir K, Swaminathan M, Blankstein R, Daubert MA. Multimodality Cardiac Imaging and the Imaging Workforce in the United States: Diversity, Disparities, and Future Directions. Circ Cardiovasc Imaging 2024; 17:e016409. [PMID: 38377238 DOI: 10.1161/circimaging.123.016409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Innovations in cardiac imaging have fundamentally advanced the understanding and treatment of cardiovascular disease. These advances in noninvasive cardiac imaging have also expanded the role of the cardiac imager and dramatically increased the demand for imagers who are cross-trained in multiple modalities. However, we hypothesize that there is significant variation in the availability of cardiac imaging expertise and a disparity in the adoption of advanced imaging technologies across the United States. To evaluate this, we have brought together the leaders of cardiovascular imaging societies, imaging trainees, as well as collaborated with national imaging accreditation commissions and imaging certification boards to assess the state of cardiac imaging and the diversity of the imaging workforce in the United States. Aggregate data confirm the presence of critical gaps, such as limited access to imaging and imaging expertise in rural communities, as well as disparities in the imaging workforce, notably among women and underrepresented minorities. Based on these results, we have proposed solutions to promote and maintain a robust and diverse community of cardiac imagers and improve equity and accessibility for cardiac imaging technologies.
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Affiliation(s)
- Renee P Bullock-Palmer
- Clinical Associate Professor, Department of Medicine, Division of Cardiology, Thomas Jefferson University, Philadelphia, PA (R.P.B.P.)
- Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ (R.P.B.P., K.P.)
| | - Karen Flores Rosario
- Department of Medicine, Division of Cardiology (K.F.R., P.S.D., M.A.D.), Duke University Medical Center, Durham, NC
| | - Pamela S Douglas
- Department of Medicine, Division of Cardiology (K.F.R., P.S.D., M.A.D.), Duke University Medical Center, Durham, NC
| | - Rebecca T Hahn
- Department of Medicine, Columbia University Irving Medical Center, New York, NY (R.T.H.)
| | - Roberto M Lang
- Section of Cardiology, Heart and Vascular Center, University of Chicago, IL (R.M.L.)
| | | | - Monvadi B Srichai
- Department of Medicine and Radiology, Medstar Georgetown University Hospital, Medstar Heart and Vascular Institute, Washington, DC (M.B.S.)
| | - Karen G Ordovas
- Department of Radiology, University of Washington, Seattle, WA (K.G.O.)
| | - Lauren A Baldassarre
- Department of Medicine, Division of Cardiology, Yale School of Medicine, New Haven, CT (L.A.B.)
| | | | - Cory S Henderson
- Department of Medicine, Division of Cardiology, Department of Radiology, Boston Medical Center, MA (C.S.H.)
| | - Pamela K Woodard
- Department of Radiology, Mallinckrodt Institute of Radiology, Washington University, St Louis, MO (P.K.W.)
| | - Kathleen Pressoir
- Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, NJ (R.P.B.P., K.P.)
| | - Madhav Swaminathan
- Department of Anesthesiology, Cardiothoracic Division (M.S.), Duke University Medical Center, Durham, NC
| | - Ron Blankstein
- Department of Medicine and Radiology, Brigham and Women's Hospital, Boston, MA (R.B.)
| | - Melissa A Daubert
- Department of Medicine, Division of Cardiology (K.F.R., P.S.D., M.A.D.), Duke University Medical Center, Durham, NC
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Trussell TM, Kocaoglu M, Fleck RJ, Taylor MD, Zang H, Ollberding NJ, Lang SM. Extracardiac Findings on Cardiac Magnetic Resonance: A Children's Hospital Experience. Pediatr Cardiol 2023:10.1007/s00246-023-03190-1. [PMID: 37209187 DOI: 10.1007/s00246-023-03190-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
Cardiac magnetic resonance (CMR) incorporates a field of view that has the potential to capture clinically relevant extracardiac findings (ECF); however, there has been minimal investigation of ECF prevalence in children's hospitals, where the patient population varies in age and diagnosis. We retrospectively reviewed consecutive, clinically indicated, CMR studies performed at a tertiary care children's hospital during a 1-year period from January 1 to December 31, 2019. ECFs were classified as significant or non-significant based on whether they were described in the final impression of the CMR report. A total of 851 distinct patients had a CMR study during the 1-year period. Mean age was 19.5 (range 0.2; 74.2) years. A total of 254 ECFs were present in 158 of the 851 studies (18.6%) with 9.8% of all studies having significant ECFs. A total of 40.2% of ECFs were previously unknown and 9.1% (23/254) of ECFs included further recommendations (2.1% of all studies). ECFs were most often found in the chest (48%) or abdomen/pelvis (46%). Three patients were incidentally found to have malignancy (renal cell, thyroid, and hepatocellular carcinoma). Comparing studies with significant ECFs to the group without, CMR indications for biventricular CHD (43% vs 31%, p = 0.036), single ventricle CHD (12% vs 3.9%, p = 0.002), and aortopathy/vasculopathy (16% vs 7.6%, p = 0.020) were more common. The odds of significant ECF increased with increasing age (OR 1.82, 95% CI 1.10-3.01) and increased most notably between ages 14 to 33 years old. Recognition of the high percentage of ECFs remains important for timely diagnosis of these incidental findings.
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Affiliation(s)
- Taylor M Trussell
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
- Heart Institute Research Core, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Murat Kocaoglu
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
| | - Robert J Fleck
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
| | - Michael D Taylor
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
- Heart Institute Research Core, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Huaiyu Zang
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Sean M Lang
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.
- Heart Institute Research Core, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.
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