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Ethical considerations in image-based screening for coronary artery disease
1Department of Radiology, Stanford University School of Medicine, Stanford, California 94305-1025, USA. lew.wexler@stanford.edu
Topics in Magnetic Resonance Imaging : TMRI
|June 11, 2002
Summary
Coronary artery disease (CAD) remains a leading cause of death, with many sudden cardiac events occurring without prior symptoms. Advanced imaging like magnetic resonance (MR) and computed tomography (CT) offer new screening potential for early detection and prevention.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Coronary artery disease (CAD) accounts for a significant portion of deaths in the US, often with no preceding symptoms.
- Sudden cardiac death from acute myocardial infarction frequently occurs in individuals with undiagnosed CAD.
Purpose of the Study:
- To review current concepts in CAD pathophysiology and the rationale for emerging diagnostic screening tests.
- To discuss the potential value and ethical considerations of CAD screening for individual patients.
Main Methods:
- Review of current literature on CAD pathophysiology.
- Description of diagnostic tests including magnetic resonance (MR) imaging and gated computed tomography (CT).
- Discussion of MR techniques such as myocardial perfusion, stress imaging, coronary arteriography, and plaque characterization.
Main Results:
- New MR and CT imaging techniques are being developed for screening asymptomatic and symptomatic individuals for significant CAD.
- While clinical efficacy is not yet definitively proven, patient demand and screening site proliferation are increasing.
- Radiologists play a crucial role in interpreting these tests and communicating results to patients.
Conclusions:
- Emerging imaging technologies offer potential for early detection of CAD, aiming to prevent silent heart attacks.
- Understanding the pathophysiology, diagnostic rationale, and ethical implications is vital for effective CAD screening.
- Further clinical studies are needed to definitively establish the efficacy of these screening modalities.