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Requests for cardiac magnetic resonance imaging (MRI) have increased by more than 500% in the last 15 years, stressing the need for faster sequences and reporting, a specialist in cardiac and musculoskeletal MRI showed during SERAM2024, the 37th annual meeting of the Spanish Society of Medical Radiology (SERAM) currently ongoing in Barcelona.

In his presentation on “Efficient cardiac imaging: rapid protocols in the context of a high and growing demand”, Dr. Roque Oca Pernas, a specialist in cardiac and musculoskeletal MRI at Osatek Bizkaia near Bilbao, linked the exponential growth with the introduction of an increasing number of indications in clinical guidelines and the availability of better therapeutic strategies to treat patients.

‘We have increasingly sophisticated imaging technology that provides us with more information, allowing us to have a more decisive impact on the health of our patients through a more personalized approach,’ he said. ‘We have to respond to the demand for diagnostic scans in a fast and efficient way, while remaining accessible to the majority of the population.’

In the field of cardiac imaging, this means carrying out faster, more reproducible and more precise examinations. This is especially true for cardiac MRI, since these are long scans that can take up to 1 hour, and equipment is not readily available.

However cardiac MRI provides a precise view of the anatomy of the heart, a real-time view of its function, and noninvasive tissue characterization.

Rethinking Protocols to Save Time

The technique provides with very precise tissue information, without the need for biopsy. Technological advances in recent years have made available multiple new sequences that have been incorporated and added to the images that were already available, thus extending image acquisition.

‘Radiologists play a fundamental role within the multidisciplinary teams that manage patients with cardiovascular pathology or heart team, and we contribute crucial knowledge from the point of view of cardiac imaging,’ Oct said. ‘So we need to rethink our protocols, be aware of the high demand and limited accessibility, and focus not only on the correct diagnosis, but also on the efficiency of our studies.’

Optimizing the use of resources in medicine has always been one of the priorities from the point of view of medical management, and currently 80% of medical decisions are based on the result of a diagnostic imaging test, he argued.

Therefore, ‘national and international scientific societies encourage us specialists to use agile protocols that guarantee access to a greater number of patients,’ he said. 

To use agile protocols, design strategies can be employed that sometimes include artificial intelligence (AI), which helps both in image acquisition and post-processing when manipulating the images once they have been acquired, or even in the preparation of radiological reports.