Author + information
- Pamela S. Douglas, MD∗ (, )
- ACC Think Tank on the Future of Cardiac Imaging Steering Committee
- ↵∗Ursula Geller Professor of Research in Cardiovascular Disease, Duke University School of Medicine, 7022 North Pavilion, DUMC, P.O. Box 17969, Durham, North Carolina 27715
The American College of Cardiology (ACC) Think Tank on the Future of Cardiac Imaging (TT) Steering Committee would like to thank Dr. Lopez-Mattei for writing in support of multimodality imaging. As we recognized in the proceedings (1), this is an attractive concept. However, the TT participants also cautioned that prioritizing the number of modalities over expertise may be detrimental to our training and research programs and possibly patient care. Indeed, the TT felt that achieving imaging expertise should be the primary goal, an emphasis designed to strengthen the role of cardiac imaging in outcomes-based care.
The TT also agrees with Dr. Lopez-Mattei’s concern regarding the potential for referral bias and competition if the modalities are siloed. To this end, we discussed value-based care in imaging and took a practical approach to change. Our recommendations accommodated the current reality of physically separate laboratories in most large centers, and the substantial legacy of imagers practicing in only 1 or 2 modalities. Thus, the TT recommended: Recasting multimodality imaging as a service characteristic rather than an individual person’s scope of practice (1). We believe these points look to the future by building on current care delivery and workforce constraints.
Training is another challenge. The Core Cardiology Training Symposium 4 is to be applauded for addressing multimodality imaging (2), albeit with content similar to the ACC’s 2008 document (3). However, the 7-page section is contrasted with 42 pages on single modalities. Further, it does not require multimodality training when most directly addressing single versus multimodality training during general fellowship (key principle #6: concurrent training across multiple imaging modalities is encouraged when possible) (2). Closely aligned to training guidelines is the development of a multimodality core curriculum; we proposed a template in 2007, which is perhaps a starting point for much needed societal efforts (4).
If we are to realize the dream of multimodality imaging, we will have to address these and other concerns. A focus on communications and finding solutions will surely help us advance our field.
Please note: Dr. Douglas has received research grants from HeartFlow and GE Healthcare; and serves on a Data Safety and Monitoring Board for GE Healthcare.
- American College of Cardiology Foundation
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