Artificial Intelligence Advances in the World of Cardiovascular Imaging

The tremendous advances in digital information and communication technology have entered everything from our daily lives to the most intricate aspects of medical and surgical care. These advances are seen in electronic and mobile health and allow many new applications to further improve and make the diagnoses of patient diseases and conditions more precise. In the area of digital radiology with respect to diagnostics, the use of advanced imaging tools and techniques is now at the center of evaluation and treatment. Digital acquisition and analysis are central to diagnostic capabilities, especially in the field of cardiovascular imaging. Furthermore, the introduction of artificial intelligence (AI) into the world of digital cardiovascular imaging greatly broadens the capabilities of the field both with respect to advancement as well as with respect to complete and accurate diagnosis of cardiovascular conditions. The application of AI in recognition, diagnostics, protocol automation, and quality control for the analysis of cardiovascular imaging modalities such as echocardiography, nuclear cardiac imaging, cardiovascular computed tomography, cardiovascular magnetic resonance imaging, and other imaging, is a major advance that is improving rapidly and continuously. We document the innovations in the field of cardiovascular imaging that have been brought about by the acceptance and implementation of AI in relation to healthcare professionals and patients in the cardiovascular field.

Recent Trends and Potential Drivers of Non-invasive Cardiovascular Imaging Use in the United States of America and England

Background: Non-invasive Cardiovascular imaging (NICI), including cardiovascular magnetic resonance (CMR) imaging provides important information to guide the management of patients with cardiovascular conditions. Current rates of NICI use and potential policy determinants in the United States of America (US) and England remain unexplored.Methods: We compared NICI activity in the US (Medicare fee-for-service, 2011–2015) and England (National Health Service, 2012–2016). We reviewed recommendations related to CMR from Clinical Practice Guidelines, Appropriate Use Criteria (AUC), and Choosing Wisely. We then categorized recommendations according to whether CMR was the only recommended NICI technique (substitutable indications). Reimbursement policies in both settings were systematically collated and reviewed using publicly available information.Results: The 2015 rate of NICI activity in the US was 3.1 times higher than in England (31,055 vs. 9,916 per 100,000 beneficiaries). The proportion of CMR of all NICI was small in both jurisdictions, but nuclear cardiac imaging was more frequent in the US in absolute and relative terms. American and European CPGs were similar, both in terms of number of recommendations and proportions of indications where CMR was not the only recommended NICI technique (substitutable indications). Reimbursement schemes for NICI activity differed for physicians and hospitals between the two settings.Conclusions: Fee-for-service physician compensation in the US for NICI may contribute to higher NICI activity compared to England where physicians are salaried. Reimbursement arrangements for the performance of the test may contribute to the higher proportion of nuclear cardiac imaging out of the total NICI activity. Differences in CPG recommendations appear not to explain the variation in NICI activity between the US and England.