Present Practices & Future Directions in Cardiac Imaging: The Cardiologist's Perspective, 2008-2011

Published by: IMV Medical Information Division, Inc.

Published: Jan. 1, 2009 - 150+ Pages

Table of Contents

I. Objectives

II. Executive Summary

III. Methodology

IV. Findings

A. Cardiologists’ Use of Diagnostic Imaging by Major Cardiac Condition

Diagnostic Evaluation of New and Chronic Angina Pectoris Conditions

1. Diagnostic Evaluation of New Angina Pectoris Conditions

2. Diagnostic Evaluation of Chronic Angina Pectoris Conditions

3. Diagnostic Evaluation of Non-Specific Chest Pain

4. Diagnostic Evaluation of Congestive Heart Failure

5. Diagnostic Evaluation of Recent Survivors of Myocardial Infarction

6. Diagnostic Evaluation of Syncope

7. Diagnostic Evaluation of Endocarditis

8. Diagnostic Evaluation of Valvular Heart Disease

9. Diagnostic Evaluation of Recent Survivors of Ventricular Fibrillation

10. Diagnostic Evaluation of 5-Year Post-CABG Patients

11. Diagnostic Evaluation of 6 to 12 Month Post-PCI Patients

12. Diagnostic Evaluation of Other Known Coronary Artery Disease

B. Cardiologists’ Present and Future Use by Modality

1. Cardiologists’ Use of Echocardiography: Present and Future

Modality Overview

Present Use of Echocardiography by Cardiologists

Clinical Indications for Echocardiography

Percentage of Cardiologists Ordering Echocardiography

Average Volumes of Echocardiography Procedures Ordered/Month

Percentage Change in Echocardiography Procedure Volumes, Past Three Years

Percentage of Echocardiography Procedures Referred Out

Mix of Settings for Referred Echocardiography Procedures

Echocardiography Units Owned/Leased by Respondent Practices

Brands of Echocardiography Units Owned/Leased by Respondent Practices

Future Use of Echocardiography by Cardiologists

Expected Change in Echocardiography Procedure Volumes, Next Three Years

Expected Change in Percent of Patients Referred Out for Echocardiography

Procedures

Expected Echocardiography Equipment Purchases by Respondent Practices

2. Cardiologists’ Use of Coronary Angiography(Cardiac Cath):Present and Future

Modality Overview

Present Use of Coronary Angiography by Cardiologists

Clinical Indications for Coronary Angiography (Cardiac Cath)

Percentage of Cardiologists Ordering Diagnostic Cardiac Cath

Average Number of Diagnostic Cardiac Cath Procedures Ordered/Month

Referrals of Cardiac Cath Procedures

Settings for Cardiac Cath Procedures Referred Out

Mean Number of Cardiac Cath Units Owned/Leased by Respondent Practices

Mix of Brands of Cardiac Cath Units Owned/Leased by Respondent Practices

Future Use of Coronary Angiography (Cardiac Cath)

Expected Change in Cardiac Cath Procedure Volumes, Next Three Years

Reasons for Expected Change in Cardiac Cath Procedure Volumes, Next Three Years

Expected Change in Cardiac Cath Referral Practices

Future Settings for Referred Cardiac Cath Procedures

Expected Cardiac Cath Lab Equipment Purchases by Respondent Practices

3. Cardiologists’ Use of Nuclear Medicine-SPECT and SPECT-CT: Present and Future

Modality Overview

Present Use of Nuclear Medicine - SPECT and SPECT-CT by Cardiologists

Trends in the Use of SPECT and SPECT-CT

Cardiac Indications for SPECT and SPECT-CT

Percentage of Cardiologists Ordering SPECT or SPECT-CT

Average Number of Cardiac SPECT and SPECT-CT Procedures Ordered/Month

Changes in SPECT and SPECT-CT Procedure Volumes, Past Three Years

Percentage of SPECT and SPECT-CT Procedures Referred Out

Settings for Referred Cardiac SPECT or SPECT-CT Procedures

Mean Number of SPECT or SPECT-CT Units Owned/Leased by Respondent Practices

Brands of SPECT/SPECT-CT Equipment Owned/Leased by Respondent Practices

Future Use of SPECT and SPECT-CT by Cardiologists

Expected Change in SPECT or SPECT-CT Procedure Volumes, Next Three Years

Reasons for Expected Change in SPECT and SPECT-CT Procedure Volumes, in Three Years

Expected Change in Percentage of Patients Referred Out for SPECT/SPECT-CT Procedures

Expected Usual Setting for Referred SPECT/SPECT-CT Procedures in Next Three Years

Expected SPECT or SPECT-CT Equipment Purchases by Practice Category

4. Cardiologists’ Use of Coronary CT Angiography: Present and Future

Modality Overview

Present Use of Coronary CT Angiography by Cardiologists

Cardiac Indications for Coronary CT angiography

Average Number of CT Angiography Procedures Ordered/Month

Percentage Change in CT Angiography Procedure Volumes, Past Three Years

Percentage of Coronary CTA Procedures Referred Out

Mix of Settings for CT Angiography Referred Out

CT Equipment Owned or Leased by Respondent Practices

Brands of CT Scanners Owned/Leased by Respondent Practices

Timing of CT Equipment Acquisitions

Future Use of Coronary CT Angiography by Cardiologists

Expected Change in Coronary CT Angiography Procedure Volumes, Next Three Years

Expected Change in Percentage of Referred CT Angiography Procedures

Reasons for Expected Changes in CT Angiography Procedure Referrals

Settings for Coronary CT Angiography Referred Out in Three Years

Expected CT Equipment Purchases by Respondent Practices

5. Cardiologists’ Use of CT Calcium Scoring: Present and Future

Modality Overview

Present Use of CT Calcium Scoring by Cardiologists

Cardiac Indications for CT Calcium Scoring

Percentage of Cardiologists Ordering Calcium Scoring

Average Number of CT Calcium Scoring Procedures Ordered/Month

Change in CT Calcium Scoring Procedure Volumes, Past Three Years

Percentage of CT Calcium Scoring Procedures Referred Out

Settings for Referred CT Calcium Scoring Procedures

Future Use of CT Calcium Scoring by Cardiologists

Expected Change in CT Calcium Scoring Procedure Volumes, Next Three Years

Expected Change in Percent of Patients Referred Out for CT Calcium Scoring Procedures

Expected Usual Setting for CT Calcium Scoring Procedures Referred Out, in Three Years

6. Cardiologists’ Use of MR and MR Angiography: Present and Future

Modality Overview

Present Use of MR and MR Angiography by Cardiologists

Cardiac Indications for MR and MR Angiography

Average Number of Cardiac MRA and MR Procedures Ordered/Month

Change in MRA and Other MR Procedure Volumes, Past Three Years

Percentage of Referred Cardiac MR Procedures

Settings for Referred MRA and Other MR Procedures

MR Units Owned/Leased by Respondent Practices

Future Use of Cardiac MR and MR Angiography by Cardiologists

Expected Change in MR and MR Angiography Procedure Volumes, Next Three Years

Expected Change in Percentage of Referred Cardiac MR/MRA Procedures

Expected Usual Setting for Referred Cardiac MR/MRA Procedures in Three Years .IV-108

Expected MR Equipment Purchases by Respondent Practices

7. Cardiologists’ Use of PET and PET-CT: Present and Future

Modality Overview

Present Use of PET and PET-CT by Cardiologists

Cardiac Indications for PET and PET-CT

Average Number of Cardiac PET Procedures Ordered/Month

Changes in Cardiac PET Procedure Volumes, and Reasons for Changes

Percentage of Cardiac PET and PET-CT Procedures Referred Out

Mix of Settings for Cardiac PET and PET-CT Procedures Referred Out

PET or PET-CT Equipment Owned/Leased by Respondent Practices

Future Use of Cardiac PET and PET-CT by Cardiologists

Expected Cardiac PET and PET-CT Procedure Volume Change

Expected Changes in Cardiac PET and PET-CT Procedures Referred Out

Expected Usual Setting for Cardiac PET or PET-CT Procedures Referred Out in Three Years

Expected PET or PET-CT Equipment Purchases by Cardiology Practices

C. Trends in the Future Adoption of Advanced Diagnostic Imaging Modalities

Perceived Areas of Competition with Radiologists

Cardiologists’ “Greatest Unmet Needs” in Cardiac Imaging

Cardiologists’ Motivations for Performing More Office-Based Procedures

Cardiologists’ Reasons for Plans to Acquire New Office-Based Diagnostic Imaging Equipment

Vendor Selection Criteria for New Diagnostic Imaging Equipment Acquisitions

Potential Issues in the Future Adoption of Additional Diagnostic Imaging Modalities

Cardiac Conditions Where Medical Efforts will Reduce Disease Incidence

D. Survey Respondent Demographics

Respondent Sub-Specialization

Distribution of Respondent Practice Types

Number of Cardiologists per Practice

Number and Types of Practice Office Locations

Geographic Distribution of Survey Respondents

Abstract

Rapid advances in imaging technology have dramatically expanded the diagnostic capabilities of physicians in general and cardiologists in particular. An increasing number of cardiologists are evaluating the feasibility of using new imaging technologies to enhance patient care. In addition to deciding which imaging modalities are most effective, physicians will choose whether to acquire these new technologies or refer patients to other locations. This report will provide insight into cardiologists’ roles in ordering and performing cardiac imaging procedures today and in the years to come. The report is based on interviews with 220 cardiologists to learn which imaging scans are currently ordered by cardiac condition, where these scans are performed (in their office or in local hospitals or imaging centers), and what they expect to order for these same conditions 3 years from now. It includes comparisons to data collected 2 years ago.

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