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Challenges and opportunities of CMR in Europe

Lecture Session VI

Lecture session VI was a joint collaboration with ESCR (European Society of Cardiac Radiology) and discussed the challenges and opportunities of CMR in Europe.

The first talk was an update on the EuroCMR registry given by Dr Oliver Bruder. The database comprises over 57.000 entries from 57 centres and 15 countries in Europe.  Several publications have originated from the registry covering indications, diagnosis, management, cost-effectiveness and safety in CMR, as well as a study on HCM and prognosis. Further information regarding the EuroCMR registry can be found here.

The second talk was an update on the ESCR registry given by Professor Matthias Gutberlet. Although having started later than the EuroCMR registry, it now comprises over 120.000 entries from 28 countries. As opposed to the EuroCMR registry, the ESCR registry includes entries from both CMR and CT, which are required for certification purposes. The main indications for CMR are similar to the EuroCMR registry and include coronary artery disease and cardiomyopathy. Further information regarding the ESCR registry can be found here

The third presentation was perhaps the most controversial as Professor Holger Thiele had to comment on “CMR between cardiology and radiology: how to strike the balance”, giving his opinion as a cardiologist in the German setting. German board certification in radiology automatically grants competency in CMR irrespective of the expertise, whilst cardiologists follow the ESC Certification process which includes the CMR exam. From the discussion it arose that there is a lot of opportunities to join forces in creating common training and education pathways across the two specialties. In conclusion, as cardiology and radiology have different strengths, collaboration between these specialities is key for excellence in CMR.

The fourth talk reported the top 10 indications in CMR by Dr Ingo Eitel. The indications were accompanied with examples and are listed as follows:

  1. Myocarditis
  2. Unclear heart failure/cardiomyopathy
  3. Viability
  4. Suspected coronary artery disease - ischaemia testing
  5. Acute coronary syndromes with unobstructed coronary arteries
  6. Risk stratification after myocardial infarction
  7. Cardiac masses
  8. Congenital heart disease
  9. Electrophysiology
  10. Valve disease. In summary, CMR has the highest clinical impact with correct indications

The last talk was presented by Professor Luigi Natale on Fusion imaging: PET-MR and SPECT-CT. Hybrid imaging relies on accurate spatial alignment between two separate datasets for integration into a fused image that provides information beyond that achievable by a single technique. Small studies suggest that PET-MR has potential for viability assessment, atherosclerotic plaque characterization and in cardiac sarcoidosis, but the incremental benefit of combined imaging still needs to be ascertained.  

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.