A Multicenter Cardiovascular MR Network for Tele-Training and Beyond: Setup and Initial Experiences

Muehlberg, Fabian; Neumann, Daniel; Knobelsdorff‐Brenkenhoff, Florian von; Traber, Julius; Alwardt, Nils; Schulz‐Menger, Jeanette

doi:10.1016/j.jacr.2015.03.006

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…Two papers focused on tele-training of medical staff. One study [ 25 ] reported a tele-training trial for CMR in Germany. In this study, network teaching for CMR reduced off-site training to only five weeks.…”

Section: Discussionmentioning

confidence: 99%

Telecardiology in Rural Practice: Global Trends

Yamano

Kotani

Kitano

et al. 2022

IJERPH

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The management of cardiovascular diseases in rural areas is plagued by the limited access of rural residents to medical facilities and specialists. The development of telecardiology using information and communication technology may overcome such limitation. To shed light on the global trend of telecardiology, we summarized the available literature on rural telecardiology. Using PubMed databases, we conducted a literature review of articles published from January 2010 to December 2020. The contents and focus of each paper were then classified. Our search yielded nineteen original papers from various countries: nine in Asia, seven in Europe, two in North America, and one in Africa. The papers were divided into classified fields as follows: seven in tele-consultation, four in the telemedical system, four in the monitoring system, two in prehospital triage, and two in tele-training. Six of the seven tele-consultation papers reported the consultation from rural doctors to urban specialists. More reports of tele-consultations might be a characteristic of telecardiology specific to rural practice. Further work is necessary to clarify the improvement of cardiovascular outcomes for rural residents.

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Section: Discussionmentioning

confidence: 99%

Telecardiology in Rural Practice: Global Trends

Yamano

Kotani

Kitano

et al. 2022

IJERPH

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“…LGE sequences are a mandatory part of most CMR protocols in ischemic and non-ischemic cardiomyopathy [ 8 ]. The broader spread of CMR in clinical routine has several implications: demand for CMR access increases and there is a continuous need for fast scanning protocols [ 14 ]. While segmented LGE sequences may give excellent image quality under stable sinus rhythm and sufficient breathhold the issue of time investment prevails.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, standard segmented LGE sequences typically require 5 to 10 min of scan time for complete myocardial coverage. There is a need for faster and more efficient imaging in CMR in order to enable a more wide-spread use of CMR in clinical routine as well as in smaller institutions where access to CMR scanners maybe more restricted [ 14 ]. CMR also competes with other non-invasive imaging techniques in terms of scan time optimization leading to efforts for faster standardized CMR scan protocols [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Muehlberg

Arnhold

Fritschi

et al. 2018

Journal of Cardiovascular Magnetic Resonance

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BackgroundSegmented phase-sensitive inversion recovery (PSIR) cardiovascular magnetic resonance (CMR) sequences are reference standard for non-invasive evaluation of myocardial fibrosis using late gadolinium enhancement (LGE). Several multi-slice LGE sequences have been introduced for faster acquisition in patients with arrhythmia and insufficient breathhold capability.The aim of this study was to assess the accuracy of several multi-slice LGE sequences to detect and quantify myocardial fibrosis in patients with ischemic and non-ischemic myocardial disease.MethodsPatients with known or suspected LGE due to chronic infarction, inflammatory myocardial disease and hypertrophic cardiomyopathy (HCM) were prospectively recruited. LGE images were acquired 10–20 min after administration of 0.2 mmol/kg gadolinium-based contrast agent. Three different LGE sequences were acquired: a segmented, single-slice/single-breath-hold fast low angle shot PSIR sequence (FLASH-PSIR), a multi-slice balanced steady-state free precession inversion recovery sequence (bSSFP-IR) and a multi-slice bSSFP-PSIR sequence during breathhold and free breathing. Image quality was evaluated with a 4-point scoring system. Contrast-to-noise ratios (CNR) and acquisition time were evaluated. LGE was quantitatively assessed using a semi-automated threshold method. Differences in size of fibrosis were analyzed using Bland-Altman analysis.ResultsThree hundred twelve patients were enrolled (n = 212 chronic infarction, n = 47 inflammatory myocardial disease, n = 53 HCM) Of which 201 patients (67,4%) had detectable LGE (n = 143 with chronic infarction, n = 27 with inflammatory heart disease and n = 31 with HCM). Image quality and CNR were best on multi-slice bSSFP-PSIR. Acquisition times were significantly shorter for all multi-slice sequences (bSSFP-IR: 23.4 ± 7.2 s; bSSFP-PSIR: 21.9 ± 6.4 s) as compared to FLASH-PSIR (361.5 ± 95.33 s). There was no significant difference of mean LGE size for all sequences in all study groups (FLASH-PSIR: 8.96 ± 10.64 g; bSSFP-IR: 8.69 ± 10.75 g; bSSFP-PSIR: 9.05 ± 10.84 g; bSSFP-PSIR free breathing: 8.85 ± 10.71 g, p > 0.05).LGE size was not affected by arrhythmia or absence of breathhold on multi-slice LGE sequences.ConclusionsFast multi-slice and standard segmented LGE sequences are equivalent techniques for the assessment of myocardial fibrosis, independent of an ischemic or non-ischemic etiology. Even in patients with arrhythmia and insufficient breathhold capability, multi-slice sequences yield excellent image quality at significantly reduced scan time and may be used as standard LGE approach.Trial registrationISRCTN48802295 (retrospectively registered).

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“…Already now, there are attempts how to overcome the latter obstacles and to enable the use of CMR in accordance with the guidelines: Recent large-scale studies demonstrated the diagnostic accuracy of CMR and its superiority in some indications [ 4 ]; prognostic data are available that demonstrate the benefit of CMR [ 42 ]; there are studies that demonstrate the potential for saving resources by using CMR [ 43 ]; structures for acquiring CMR skills including e-based learning are evolving [ 44 ]; and CMR imaging became faster and the user interfaces easier to handle.…”

Section: Discussionmentioning

confidence: 99%

Role of cardiovascular magnetic resonance in the guidelines of the European Society of Cardiology

Knobelsdorff‐Brenkenhoff¹,

Schulz‐Menger²

2016

Journal of Cardiovascular Magnetic Resonance

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145

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BackgroundDespite common enthusiasm for cardiovascular magnetic resonance (CMR), its application in Europe is quite diverse. Restrictions are attributed to a number of factors, like limited access, deficits in training, and incomplete reimbursement. Aim of this study is to perform a systematic summary of the representation of CMR in the guidelines of the European Society of Cardiology (ESC).MethodsTwenty-nine ESC guidelines were screened for the terms “magnetic”, “MRI”, “CMR”, “MR” and “imaging”. As 3 topics were published twice (endocarditis, pulmonary hypertension, NSTEMI), 26 guidelines were finally included. MRI in the context of non-cardiovascular examinations was not recognized. The main CMR-related conclusions and, if available, the level of evidence and the class of recommendation were extracted.ResultsFourteen of the 26 guidelines (53.8 %) contain specific recommendations regarding the use of CMR. Nine guidelines (34.6 %) mention CMR in the text, and 3 (11.5 %) do not mention CMR. The 14 guidelines with recommendations regarding the use of CMR contain 39 class-I recommendations, 12 class-IIa recommendations, 10 class-IIb recommendations and 2 class-III recommendations. Most of the recommendations have evidence level C (41/63; 65.1 %), followed by level B (16/63; 25.4 %) and level A (6/63; 9.5 %). The four guidelines, which absolutely contained most recommendations for CMR, were stable coronary artery disease (n = 14), aortic diseases (n = 9), HCM (n = 7) and myocardial revascularization (n = 7).ConclusionsCMR is represented in the majority of the ESC guidelines. They contain many recommendations in favour of the use of CMR in specific scenarios. Issues regarding access, training and reimbursement have to be solved to offer CMR to patients in accordance with the ESC guidelines.

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A Multicenter Cardiovascular MR Network for Tele-Training and Beyond: Setup and Initial Experiences

Cited by 8 publications

References 26 publications

Telecardiology in Rural Practice: Global Trends

Telecardiology in Rural Practice: Global Trends

Comparison of fast multi-slice and standard segmented techniques for detection of late gadolinium enhancement in ischemic and non-ischemic cardiomyopathy – a prospective clinical cardiovascular magnetic resonance trial

Role of cardiovascular magnetic resonance in the guidelines of the European Society of Cardiology

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