Cardiovascular Business - October/November 2007 - (Page 28) CardiaC pet/Ct steps iNtO the CliNiCal maiNstream A: images show a 62-year-old female with a body mass index of 32 with atypical chest pain and non-specific ekG changes. rb-82 Pet/Ct demonstrates reversible anterior wall defect compatible with ischemia. Cardiac catherization revealed an 85 percent stenosis in the proximal lad territory. B: images of a 75-year-old man with typical chest pain and body mass index of 25. rb-82 MPi Pet/Ct shows lateral wall ischemia. a 95 percent stenosis of the lateral circumflex territory was discovered at cardiac catheterization. images courtesy of ronald korn, Md, scottsdale Medical imaging. A B portion of the exam. As part of their cardiac imaging protocol, Scottsdale Medical Imaging performs coronary CT artery calcification scoring to evaluate plaque build up. If a patient presents as intermediate to high risk, or if the referring physician wants to find out the functional significance of the patient’s calcium score, the patient is referred for a PET/CT. Building the practice Inaugurating a cardiac PET/CT practice for cardiologists or radiologists is not simply a matter of throwing open the doors and announcing to the world that a group is providing these imaging services. A practice has to build relationships with cardiologists in their area and assure them that they are providing a complementary service, not competition, for patients. “It is a process of gaining their trust,” Korn says. “SPECT imaging is not going away in the near future. But there are certain patients in which cardiologists are going to have a really difficult time interpreting their SPECT studies. We’re offering them a solution for their most difficult patients.” To Korn, this approach has been received very well by cardiologists in the Phoenix area. Once they realized that Scottsdale Medical Imaging was providing a service for their overflow and difficult cases and not competing with them, they began referring their patients to the practice for cardiac PET/CT. “We turned our rubidium imaging into more of a consultation service than cardiac PET/CT service,” Korn says. “That has been fairly effective and has helped to grow the practice.” Another element to building a successful cardiac PET/CT service line is to provide prompt follow up on the results to the referring clinician. “Every MPI PET/CT that has a positive or negative value is communicated to the referring cardiologist within a few hours of completing the exam,” Korn says. “We also follow up on the patient’s status so that we become part of the clinical team rather than separate from it. That helped a lot in building our consultative relationships.” In addition, when providing in-patient service at Scottsdale Healthcare, Korn and his colleagues at Scottsdale Medical Imaging read the in-patient SPECT exams. When there are equivocal or non-diagnostic SPECT studies, they have been able to use the radiology report to educate both patients and clinicians on the benefits of obtaining a cardiac PET/CT exam. “I think this is a very useful way of appropriately utilizing the practice to build the practice,” he says. Referring physician education has proven to be one of the most effective tools that Scottsdale Medical Imaging has used to grow its cardiac PET/CT service. “We brought out a variety of nationally recognized experts who met one-on-one with cardiologists in our area to explain 28 Cardiovascular Business October/November 2007
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