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Cardiovascular (CV) imaging is evolving rapidly, placing new demands on our profession for training, education, and advocacy. It is likely that the need for CV imaging will continue to increase over the coming years because of the changes in CV disease epidemiology, the aging population, the rapid changes in technology, and the need for enhanced value over volume. Over the past year, we have discussed many contemporary issues in CV imaging, including the move toward multimodality imaging. In this regard, it is worthwhile to review the approach CV imaging professional societies have taken in the United States and simultaneously learn from our European colleagues, who are undertaking a new initiative to combine noninvasive imaging under 1 multimodality professional group.
Cardiovascular Imaging Professional Societies in the United States
In the United States, there exist several primary CV imaging societies, each focused on a specific modality. Many of these societies are well established, with decades of experience and loyal membership. They were formed, for the most part, around specific techniques. This paralleled the academic formation of these subspecialties and the typical divisions that exist within cardiology departments.
Each society typically has its own member activities, with a separate educational meeting and a separate journal. Over the years, the subspecialty societies have worked cooperatively with one another on clinical statements and/or guidelines, advocacy, training, and other issues in the interest of patient care and advancing the field. In 2008, the American College of Cardiology formed the Cardiovascular Imaging Council to provide a forum for all the subspecialty societies to come together, and this council evolved in 2011 to a formal section of the American College of Cardiology, the Cardiovascular Imaging Section. The Section, which includes over 3,600 members with a specific clinical or professional interest in imaging, is a forum in which they can advance their professional priorities, offer input into the coordination of imaging activities within the College, and facilitate networking with peers in their field. The Section continues to be governed by the Imaging Leadership Council, which includes 2 representatives each from the American College of Cardiology, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the Society for Cardiovascular Angiography and Interventions, the Society of Cardiovascular Computed Tomography, and the Society for Cardiovascular Magnetic Resonance, as well as pediatric and adult congenital representatives.
Cardiovascular Imaging Professional Societies in Europe
Similarly, our European colleagues have had several subspecialty CV imaging groups, all organized under the European Society of Cardiology (ESC). There was a working group for cardiac magnetic resonance, nuclear cardiology, cardiac computed tomography, and the European Association of Echocardiography. In January 2014, the ESC moved to integrate all these working groups into 1 unified multimodality structure called the European Association of Cardiovascular Imaging (EACVI). The unified structure incorporates all noninvasive imaging methods and promotes a collaborative, patient-focused approach to CV imaging in Europe and worldwide. The rationale for the creation of an imaging association that represents all noninvasive CV imaging is based on
• the need to design rational diagnostic pathways in which imaging modalities do not compete against one another but are integrated in a cost-effective strategy in the interest of patient health and economic sustainability,
• the expectation of today's trainees for comprehensive training in CV imaging rather than in a single imaging modality, and
• the need for evidence- and expert-based algorithms and flowcharts in the appropriate use of CV imaging across imaging modalities.
In the “unified” EACVI, each imaging modality is represented by a section, complementing the core body of the EACVI board. Under this new organization, members maintain access to all educational materials and resources of the EACVI, and they pay reduced fees for the main meetings, courses, and certification exams. In addition, members will also benefit from a series of tailored initiatives that will serve to strengthen the use of CV imaging in a meaningful way. The unified EACVI is committed to providing a high standard of professional excellence by offering suitable training and education programs in noninvasive CV imaging. Patient-centered, rather than technology-centered, research and clinical practice will be promoted. Through its platform of research, the unified EACVI will offer the opportunity to construct large databases to bring the best evidence-based care to our patients, in which accredited laboratories or certified members can participate. The unified EACVI will combine previously separate efforts in education, certification, and research in CV imaging and thereby improve their effectiveness. A major future goal is to strengthen the representation of CV imaging within the ESC and position the ESC and EACVI as the representative CV multimodality imaging bodies in European Union institutions.
To date, the U.S. imaging society model has worked very well for imagers and in the house of cardiology, with increasing cooperation among different modalities and representative societies. The European model, with 1 entity representing all CV imagers' interests, also holds great appeal. Ultimately, all CV imaging societies have the same goals—to support CV teams in improving heart health and patient care—whether in the United States or Europe. As we all move into the future, we should look to the collaborative and inclusive approach adopted by the EACVI and emulate this spirit of collaboration wherever possible.
Dr. Weissman is the Immediate Past Chair, Cardiovascular Imaging Section Leadership Council. Dr. Lancellotti is the President, European Association of Cardiovascular Imaging.
- American College of Cardiology Foundation