Cardiac MRI has evolved since the late 1980’s until the present very slowly. When I first started doing MRI’s clinically (1991), CMRI wasn’t being performed clinically. The technology to perform clinically relevant exams was not yet developed. By the mid 1990’s, technology development was such that CMRI was now a viable technique. Still, some significant hurdles needed to be conquered.
MRI, in general, was time consuming, expensive and not readily available. CMRI was an unproven modality at this point and Physicians were not used to using this tool. Having physician buy-in is always an important factor in any modalities acceptance. Echocardiography was a proven modality, used in physicians offices (readily available) and was supported by research data.
As technology developed rapidly and research data was compiled for CMRI’s efficacy, it became clinically more relevant. The current most common applications for CMRI are Viability (post AMI), function (valvular and myocardial), and cardiac masses.
The center, in which I currently work (William Beaumont Hospital RO) Heart and Vascular (see photo below), began a concerted CMRI program in 2001. Initially research, our program developed rapidly into a viable research and clinical program. Once the Cardiologist’s and Surgeons were exposed to what CMRI had to offer, the referrals increased dramatically. Pre surgical planning, Electrophysiology planning and Myocardial viability are the most common referrals.
CMRI may not be a viable venture for all institutions or imaging facilities. We currently average between 600 and 700 Cardiac procedures a year. The routine clinical procedures that are performed in our suite are essential to our programs viability (no pun intended). We are contacted by other facilities to perform CMRI exams on their patients because they don’t have the availability or technology.
Our program would not be successful without the support of many people. Peter and Florine Ministrelli made the initial investment to have an MRI scanner sited in the Heart and Vascular Center dedicated to all CMRI procedures performed at our institution. The Cardiologist’s and Radiologist’s have supported the process, and the administration of our institution have supported our endeavor.
The future looks great as we continue to develop the CMRI program. CMRI stress testing is now proven and supported by research data compared to the current testing methods. CMRI stress testing is sure to be the next expansion of our program.
CMRI is here to stay and is developing more rapidly than ever. CMRI and its applications will continue to grow as technology rapidly advances.
