Cardiovascular MRI was the focus of a four-day standing-room-only meeting recently for a rapidly growing worldwide base of cardiologists and radiologists. The occasion was the Fifth Annual Scientific Sessions of the Society of Cardiovascular Magnetic Resonance (Orlando, Fla., January 24th-27th, 2002).

Cardiovascular MRI presently occupies a front-row seat among the hottest medical imaging market segments worldwide. This position, while hardly an overnight success story, comes amidst continuing improvements in equipment and software that make these procedures increasingly valuable to physicians. With reimbursement in place and expected tweaking of codes, a significant installed base that continues to swell, and training opportunities for M.D.s and techs, the stage appears set for a significant increase in these procedures over the next two years.

While some industry observers have speculated about the opportunities for arm-wrestling between cardiologists and radiologists over the spoils of this technology, the group in Orlando seemed decidedly upbeat concerning the need for working together. OK, the meeting may have been in a Disney facility, but we can still dream a little!

Seriously, the challenges of performing clinical cardiovascular MRI studies are not for the faint of heart, and benefit substantially from a collaborative approach between the specialties of imaging science and cardiovascular disease states. Solo flyers may wind up like Icarus, while team players may soar like the Wright Brothers. Remember, this is still the early stage of this market, and significant improvements can be expected and counted upon.

Cardiac MRI imaging procedures today provide solid images for assessing cardiac function, viability and perfusion (though there is presently no contrast agent specifically indicated for use in cardiac MRI perfusion procedures). These studies are performed in traditional 1.5T magnets supplemented with special power supplies, coils and software for pulse sequences and image analysis (these studies absolutely depend on high-performance software). The vascular applications also provide outstanding information on blood-flow volume and velocity within arteries, veins and ventricles, throughout the body.

Reimbursement is available, and the CPT codes are being re-evaluated in light of the potential expected growth in their use.

One of the burning questions from the meeting was the potential impact on present cardiovascular imaging modalities, including echocardiography, nuclear medicine, including PET, and cardiac cath labs. While the meeting attendees were unable to articulate any sort of environmental impact statement, the common expectation is for MRI to occupy a niche that adds to the total count of cardiovascular procedures. No current imaging modality will be eliminated or supplanted, however all of their roles may change in response to the capabilities of MRI, the new kid on the block in cardiovascular disease diagnosis.

So all the ingredients seem to be in place — patients with a medical need, equipment, software, reimbursement, trained staff and physicians — whoa, stop right there. Training and education seem to be the current Achilles heel, but this will work itself out over the next year or so, given the expected growth in demand for these procedures. And by the way, everyone involved needs training and education from both sides of the fence.

There is presently no significant turf war in this field, so let’s keep it that way. The only reason that neither side has launched an assault to own this technology may be due to the sheer complexity of applying MRI technology to cardiovascular disease. The disease is obviously complex enough to occupy the top spot as the leading cause of death worldwide. In the challenge to diagnose and treat this multi-faceted circulatory disease, there is more than enough room for dedicated professionals to jump on board this bandwagon and roll up their sleeves — there is plenty of work yet to come, and plenty of reason to get on with it too.

Doug Orr, president of J&M Group (Ridgefield, Conn.), consults with medical device companies in strategy and business development for emerging growth markets, notably radiology and cardiology. Comments and suggestions can be sent to dforr@aol.com.