European Society Of Cardiovascular Radiology Research Articles

Standards for conducting and reporting consensus and recommendation documents: European Society of Cardiovascular Radiology policy from the Guidelines Committee

Cardiovascular imaging is exponentially increasing in the diagnosis, risk stratification, and therapeutic management of patients with cardiovascular disease. The European Society of Cardiovascular Radiology (ESCR) is a non-profit scientific medical society dedicated to promoting and coordinating activities in cardiovascular imaging. The purpose of this paper, written by ESCR committees and Executive board members and approved by the ESCR Executive Board and Guidelines committee, is to codify a standardized approach to creating ESCR scientific documents. Indeed, consensus development methods must be adopted to ensure transparent decision-making that optimizes national and global health and reaches a certain scientific credibility. ESCR consensus documents developed based on a rigorous methodology will improve their scientific impact on the management of patients with cardiac involvement.Critical relevance statementThis document aims to codify the methodology for producing consensus documents of the ESCR. These ESCR indications will broaden the scientific quality and credibility of further publications and, consequently, the impact on the diagnostic management of patients with cardiac involvement.Key PointsCardiovascular imaging is exponentially increasing for diagnosis, risk stratification, and therapeutic management.The ESCR is committed to promoting cardiovascular imaging.A rigorous methodology for ESCR consensus documents will improve their scientific impact.

Competence of radiologists in cardiac CT and MR imaging in Europe: insights from the ESCR Registry

RationaleTo provide an overview of the current status of cardiac multimodality imaging practices in Europe and radiologist involvement using data from the European Society of Cardiovascular Radiology (ESCR) MRCT-registry.Materials and methodsNumbers on cardiac CT and MRI examinations were extracted from the MRCT-registry of the ESCR, entered between January 2011 and October 2023 (n = 432,265). Data collection included the total/annual numbers of examinations, indications, complications, and reporting habits.ResultsThirty-two countries contributed to the MRCT-registry, including 29 European countries. Between 2011 and 2022, there was a 4.5-fold increase in annually submitted CT examinations, from 3368 to 15,267, and a 3.8-fold increase in MRI examinations, from 3445 to 13,183. The main indications for cardiac CT were suspected coronary artery disease (CAD) (59%) and transcatheter aortic valve replacement planning (21%). The number of patients with intermediate pretest probability who underwent CT for suspected CAD showed an increase from 61% in 2012 to 82% in 2022. The main MRI indications were suspected myocarditis (26%), CAD (21%), and suspected cardiomyopathy (19%). Adverse event rates were very low for CT (0.3%) and MRI (0.7%) examinations. Reporting of CT and MRI examinations was performed mainly by radiologists (respectively 76% and 71%) and, to a lesser degree, in consensus with non-radiologists (19% and 27%, respectively). The remaining examinations (4.9% CT and 1.7% MRI) were reported by non-radiological specialties or in separate readings of radiologists and non-radiologists.ConclusionsReal-life data on cardiac imaging in Europe using the largest available MRCT-registry demonstrate a considerable increase in examinations over the past years, the vast majority of which are read by radiologists. These findings indicate that radiologists contribute to meeting the increasing demands of competent and effective care in cardiac imaging to a relevant extent.Clinical relevance statementThe number of cardiac CT and MRI examinations has risen over the past years, and radiologists read the vast majority of these studies as recorded in the MRCT-registry.Key Points• The number of cardiac imaging examinations is constantly increasing.• Radiologists play a central role in providing cardiac CT and MR imaging services to a large volume of patients.• Cardiac CT and MR imaging examinations performed and read by radiologists show a good safety profile.Graphical

Standardized Medical Terminology for Cardiac Computed Tomography 2023 Update: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), American Association of Physicists in Medicine (AAPM), American College of Radiology (ACR), North American Society for Cardiovascular Imaging (NASCI), and Radiological Society of North America (RSNA) with endorsement by the Asian Society of Cardiovascular Imaging (ASCI), the European Association

Since the emergence of cardiac computed tomography (Cardiac CT) at the turn of the 21st century, there has been an exponential growth in research and clinical development of the technique, with contributions from investigators and clinicians from varied backgrounds: physics and engineering, informatics, cardiology, and radiology. However, terminology for the field is not unified. As a consequence, there are multiple abbreviations for some terms, multiple terms for some concepts, and some concepts that lack clear definitions and/or usage. In an effort to aid the work of all those who seek to contribute to the literature, clinical practice, and investigation of the field, the Society of Cardiovascular Computed Tomography updates a standard set of medical terms commonly used in clinical and research activities related to cardiac CT. Keywords: Cardiac, CT, Medical Terminology Supplemental material is available for this article. This article is published synchronously in Radiology: Cardiothoracic Imaging and Journal of Cardiovascular Computed Tomography. ©2023 Society of Cardiovascular Computed Tomography. Published by RSNA with permission.

Rising utilization of coronary CT angiography across Europe over the last decade: insights from a large prospective European registry

Abstract Background/Introduction The recently updated 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes endorse the use of coronary computed tomography angiography (CCTA) for exclusion of obstructive coronary artery disease in patients with a low clinical likelihood (Class I, LOE B). Higher demand for CCTA requires broad availability, inevitably involving smaller healthcare providers, such as non-academic hospitals and private practices. Nevertheless, most published data on CCTA image quality and safety rely on exams performed in high-volume academic centers, and little is known about CCTA in non-academic settings. Purpose To investigate the utilization of CCTA across Europe over the last decade, focusing on differences between academic and non-academic centers. Methods We included patients with stable chest pain and suspected coronary artery disease (CAD) who received CCTA and were included in the European Society of Cardiovascular Radiology MR/CT registry 01/2010–01/2020. We compared CT equipment, image quality, radiation dose, the incidence of periprocedural adverse events, patient characteristics, and CCTA findings between academic (high volume university hospitals) and non-academic centers (non-academic hospitals and private practices). Results Overall, 64,317 patients (41.2% women; age 60±13 years) from 212 sites across 19 European countries were included. Academic centers submitted most cases in 2010—2014 (51.6%), whereas non-academic centers accounted for 71.3% of records in 2015–2020. While non-academic centers used less advanced technology, radiation dose remained low (4.54 [interquartile range (IQR) 2.28–6.76] mSv) with a 30% decline of high-dose scans (>7 mSv) over time. Diagnostic image quality was reported in 97.7% of cases, and the rate of acute scan-related events was low (0.4%) (Figure 1). From 2010–2014 to 2015–2020, CCTA nearly doubled in patients with low to intermediate pretest-probability, women >50, and 40–60 years old men (Figure 2). CAD presence and extent decreased slightly over time (prevalence: 2010–2014: 41.5% vs. 2015–2020: 40.6%), (multi-vessel disease in those with CAD: 2010–2014: 61.9% vs. 2015–2020: 55.9%; all p<0.01). Conclusion CCTA expands rapidly to non-academic centers across Europe, increasing availability while maintaining relatively low radiation dose, high diagnostic image quality, and safety. Broad availability of high-quality CCTA is essential for a successfully implementation of the recently updated guidelines for the diagnosis and management of chronic coronary syndromes. Funding Acknowledgement Type of funding sources: None. Changes in CCTA utilizationChanges in patient characteristics

Current Status of Cardiovascular Imaging in Germany: Structured Data from the National Certification Program, ESCR Registry, and Survey among Radiologists.

In the light of the increasing importance of cardiovascular cross-sectional imaging in current guidelines, the goal of this study is to provide a comprehensive overview of cardiovascular imaging (CVI) offered by radiological institutions across Germany. Data were extracted from the national certification program database of the German Roentgen Society (DRG) from 2015-2021. A nationwide online survey among radiology institutes (university hospitals, non-university hospitals, and private practices) was conducted for 2019, and data was extracted from the European Society of Cardiovascular Radiology (ESCR) registry. The data collection's key points included the number of centers and individuals certified for CVI, the number of cardiac CT and MRI examinations performed, the reporting habits, and the participation in the ESCR registry. 71 centers and 1278 persons, both with a substantial increase since 2015, were registered and certified by the DRG to perform CVI. According to the survey, a total of 69,286 CT and 64,281 MRI examinations were performed annually. Data from the survey and the ESCR registry indicated that reporting was mostly done solely by radiologists or, to a lesser degree, in joint consensus meetings with non-radiologists. The overall participation rate in the ESCR registry was 48 % among the survey's participants. This comprehensive analysis demonstrates that high-quality CVI by radiologists is available nationwide. The current challenges are to provide the best medical and technical quality of CVI by radiology for patient care and to ensure economic sustainability in the German health care system to accommodate the predicted substantial need for CVI in the future. · High-quality advanced CVI service by radiologists is available nationwide.. · Highly qualified specialist knowledge is widely represented from university to private practices.. · Certification programs successfully contribute to the dissemination & deepening of CVI expertise.. · The ESCR registry is an established international tool for the documentation of CVI.. · Sieren M, Maintz D, Gutberlet M et al. Current Status of Cardiovascular Imaging in Germany: Structured Data from the National Certification Program, ESCR Registry, and Survey among Radiologists. Fortschr Röntgenstr 2022; 194: 181 - 191.

Imaging modalities in the planning of transcatheter aortic valve implantation (standardization of scanning, measurements and reporting protocols)

This review describes the state of the art on the role of various imaging modalities in pre-operative preparation to transcatheter implantation of biological aortic valve prosthesis, based on the literature data published from 2012 to 2020. One of the key source documents is the consensus of the European Society of Cardiovascular Radiology (ESCR) from 2019, providing the standardized protocols for scanning, measurements and description of the abnormalities identified. The final decision on the procedure of transcatheter aortic valve implantation should be based on the combination of all available diagnostic methods, clinical data and results of imaging by different modalities. Given the most comprehensive information content, the main diagnostic method is computed tomography. The radiologist and the multidisciplinary team should form a single entity, combining clinical and technical knowledge, discussing all the images and conclusions with other team members.

Gadolinium-based Contrast Agents for Cardiac MRI: Use of Linear and Macrocyclic Agents with Associated Safety Profile from 154 779 European Patients.

To assess current use and acute safety profiles of gadolinium-based contrast agents (GBCAs) in cardiac MRI given recent suspensions of GBCA approval. Patients were retrospectively included from the multinational multicenter European Society of Cardiovascular Radiology (ESCR) MR/CT Registry collected between January 2013 and October 2019. GBCA-associated acute adverse events (AAEs) were classified as mild (self-limiting), moderate (pronounced AAE requiring medical management), and severe (life threatening). Multivariable generalized linear mixed-effect models were used to assess AAE likelihood. A total of 154 779 patients (average age, 53 years ± 19 [standard deviation]; 99 106 men) who underwent cardiac MRI were included, the majority of whom underwent administration of GBCAs (94.2% [n = 145 855]). While linear GBCAs were used in 15.2% of examinations through 2011, their use decreased to less than 1% in 2018 and 2019. Overall, 0.36% (n = 556) of AAEs were documented (mild, 0.12% [n = 178]; moderate, 0.21% [n = 331]; severe, 0.03% [n = 47]). For nonenhanced cardiac MRI, examination-related events were reported in 2.59% (231 of 8924) of cases, the majority of which were anxiety (0.98% [n = 87]) and dyspnea (0.93% [n = 83]). AAE rates varied significantly by pharmacologic stressor, GBCA molecular structure (macrocyclic vs linear GBCA: multivariable odds ratio, 0.634; 95% confidence interval: 0.452, 0.888; P = .008), GBCA subtype, and imaging indication. Gadolinium-based contrast agent administration changed according to recent regulatory decisions, with use of macrocyclic agents almost exclusively in 2018 and 2019; these agents also demonstrated a favorable acute safety profile.Supplemental material is available for this article.© RSNA, 2020.

Acute adverse events in cardiac MR imaging with gadolinium-based contrast agents: results from the European Society of Cardiovascular Radiology (ESCR) MRCT Registry in 72,839 patients

ObjectivesTo assess the incidence of acute adverse events (AAEs) in gadolinium-enhanced cardiac magnetic resonance (CMR) imaging.MethodsGadolinium-based contrast agent (GBCA)–enhanced CMR data from the multinational, multicenter European Society of Cardiovascular Radiology MRCT Registry was included. AAE severity was classified according to the American College of Radiology Manual on Contrast Media (mild, moderate, severe). Multivariable generalized linear mixed effect models were used to assess the likelihood of AAEs in various GBCA, adjusting for pharmacological stressor, main indications (i.e., suspected or known coronary artery disease or myocarditis), age, sex, and submitting center as a random effect.ResultsIn the study population of 72,839 GBCA-enhanced CMRs, a total of 260 AAEs were reported (0.36%), with a minority of severe AAEs (n = 24, 0.033%). Allergic-like AAEs were less likely than physiologic AAEs (29% versus 71%). Patients without pharmacological stress imaging had a lower AAE rate (0.22%) compared to stress imaging (0.75%), with the highest AAE rates for regadenoson (2.95%). AAE rates also varied by GBCA subtype (overall p < 0.001). There was significant interaction between GBCA and pharmacological stressor (interaction p = 0.025), with AAE rates ranging between 0 and 10% for certain GBCA/stressor combinations. There was further marginal evidence that higher GBCA volume was associated with higher AAE incidence (OR = 1.02, p = 0.05).ConclusionGBCA-enhanced CMR imaging demonstrates low AAE rates comparable to those of other body regions. AAE likelihood correlates with GBCA subtype, pharmacological stressor, and imaging indication. Intravenous fluid administration in patients with cardiac impairment might contribute to these findings.Key Points• Acute adverse event rates in cardiac magnetic resonance (CMR) imaging with gadolinium-based contrast agents (GBCAs) are low (0.36%), especially for severe adverse events (0.033%).• Mild and moderate adverse events are more frequent during stress CMR imaging.• Physiologic AAEs are more common than allergic AAEs in CMR imaging.

Immediate Allergic Reactions to Gadolinium-based Contrast Agents: A Systematic Review and Meta-Analysis.

Immediate Allergic Reactions to Gadolinium-based Contrast Agents: A Systematic Review and Meta-Analysis.

Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR).

Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR).

Progress of the Asian Society of Cardiovascular Imaging

ASCI has continued to grow over the past 5 years since its establishment in 2006. Recent record shows total membership of 804 from 34 countries and 1,032 attendants from 32 countries at the last annual congress in Hong Kong in 2011. ASCI publishes ASCI Special Issues twice a year in the International Journal of Cardiovascular Imaging. The Asian CCT and CMR Guideline Working Group of ASCI published guidelines and protocol in the ASCI Special Issue of the International Journal of Cardiovascular Imaging in 2010. ASCI launched the [ASCI](2) (Advanced School for Core Investigators from ASCI) Program with the aim to recruit young ASCI members of high potential and train them to become representative scholars of Asia, which was met with much success in 2010 and 2011. ASCI is trying to widen its scope by collaborating with other cardiovascular imaging societies including the European Society of Cardiovascular Radiology. Multicenter trials by ASCI researchers and cardiac imaging registry in the Asian population are being designed to represent ASCI.

Strategic collaboration with the European Society of Cardiovascular Radiology (ESCR)

It is with great pleasure we welcome the European Society of Cardiovascular Radiology (ESCR) and its members to the International Journal of Cardiovascular Imaging. ESCR members will receive our Journal and several of its members will serve on our board to further improve the Journal and foster collaboration with the ESCR. The ESCR will hold its annual meeting in Athens this year on October 20 & 21; see http:// www.escr.org. European Radiology, also a Springer Journal, remains the official journal of the ESCR. To realize this collaboration, Prof Mathijs Oudkerk, MD of the University Medical Center Groningen in the Netherlands has become editorin-chief for the ESCR, while Prof Michael R. Rees, MD of the University of Bangor, Gwynedd in the UK, and Valentin Sinitsyn, MD of the Cardiology Center Tomography in Moscow, Russia have become members of the Editorial Board. Again, we look forward to a very close and stimulating collaboration with the ESCR, and in general towards the further growth of the Journal!

Fourth Congress of the European Society of Cardiovascular Radiology

Fourth Congress of the European Society of Cardiovascular Radiology

European Society of Cardio-Vascular Radiology Fourth Congress

European Society of Cardio-Vascular Radiology Fourth Congress

Continental notebook. Review of the continental radiological literature.

This notebook covers the years 1976/77. Instead of being restricted to a review of German radiological literature it now includes a survey of selected French publications. Italian and Spanish papers will be introduced in future continental notebooks. The two main French radiological journals are Journal de radiologie, d'electrologie et de medecine nucleaire and Annales de Radiologie. The first, now in its 58th year, is the official bulletin of the French Society of Radiology, and publishes the scientific programmes and reports of the society, covering both diagnostic and therapeutic aspects of radiology. The junior journal, Annales de Radiologie, 20 years of age, contains mainly radiodiagnostic publications, and regularly reports the proceedings of the European Society of Paediatric Radiology and recently of the European Society of Cardiovascular Radiology. Both journals print comprehensive summaries in English (the bibliography usually includes the Anglo-Saxon literature), and the technical quality of th...