Cardiovascular Business - July/August 2008 - (Page 14)

Technology UpdaTe › By C.P. K aiser As Real-Time 3D Echo Matures, It Finds a clinical niche Inadequate reimbursement could hamper widespread adoption of multidimension technique W 14 cardiovascular Business ith an aging population and the rise of obesity, cardiologists are seeing a tremendous increase in the growth of cardiovascular diseases, and noninvasive imaging is playing an increasingly critical role in diagnosis and management. Echocardiography typically has been the “go to” imaging modality for clinical cardiologists, despite a reputation that has dimmed in light of the exquisite three-dimensional images served up by cardiac CT and MRI. As the latest advancements brighten its reputation, 3D echocardiography is converting cardiologists and surgeons alike. Real-time 3D transthoracic echo (TTE) not only brings understanding to 3D anatomy, but by depicting full volumes of the heart and quantifying ventricular global and regional function, it moves aesthetically and quantitatively closer to CT and MRI, says Randolph P. Martin, MD, director of the Emory University Hospital Echocardiographic Laboratory in Atlanta, Ga. Historically, 3D echo was primarily a research tool because the data acquisition and processing was time-consuming. In the last several years, the technology has significantly improved and now four major ultrasound vendors—GE Healthcare, Siemens Medical Solutions, Toshiba America Medical Systems and Philips Medical Systems—offer some type of advanced real-time 3D TTE capability. Philips last year released the first version of a real-time 3D transesophageal echo (TEE) system. “When a certain technique is embraced by vendors, it is the best signal that it’s here to stay,” says Roberto Lang, MD, vice president of the American Society of Echocardiography (ASE) and director of the Noninvasive Cardiac Imaging Labs at the University of Chicago Medical Center. While only a handful of peer-reviewed studies can speak to the efficacy of the nascent 3D TEE technology, hundreds of studies have validated 3D TTE, Lang says. Among the findings, researchers have documented that 3D TTE is more accurate than 2D for calculating ventricular volumes; that it compares favorably with cardiac MRI, the gold standard for measuring ejection fraction; and that it has a lower intra- and interobserver variability than 2D, making it ideal for serial follow-up. Lang adds that the excellent intra- and interobserver variability of 3D echo make it ideal to study the effects of drugs because researchers would require fewer patients. July/august 2008

Table of Contents Feed for the Digital Edition of Cardiovascular Business - July/August 2008

Cardiovascular Business - July/August 2008 Table of Contents First Word Cover Story: Planning for the Ideal Cath Lab Requires the Multidisciplinary Approach Clinical Study Digest: Cell Phone Technology Speeds Ecgs As Real-Time 3d Echo Matures, It Finds a Clinical Niche Ecg Image Management Brings Increased Productivity and Confidence Overcoming Barriers to Cath Lab Inventory Control Maximizing Reimbursement, Minimizing Penalties News & Views Calendar Reader Resources The Back Page

Cardiovascular Business - July/August 2008

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