Worldwide variation in cardiovascular magnetic resonance practice models

Area of Science:

• Cardiology
• Medical Imaging
• Radiology

Background:

• Cardiovascular magnetic resonance (CMR) is increasingly used globally for diagnosing and managing cardiac and vascular conditions.
• Understanding regional utilization and practice variations between high- and low-volume centers is crucial for optimizing CMR use.

Purpose of the Study:

• To assess the global utilization of cardiovascular magnetic resonance (CMR).
• To identify practice differences in CMR use between high-volume and low-volume centers worldwide.
• To explore barriers to CMR adoption and growth in different global regions.

Main Methods:

• An electronic survey was conducted by the Society for Cardiovascular Magnetic Resonance (SCMR) targeting CMR practitioners and developers globally.
• Data from 2017 were collected, merged, and curated, with responses analyzed by region, country, practice volume, and demographics.
• 1092 responses from 70 countries were included in the analysis.

Main Results:

• CMR is predominantly performed in academic and hospital settings, with adult cardiologists as the main referring providers.
• Cardiomyopathy evaluation was the leading indication in both high- and low-volume centers.
• High-volume centers more frequently used CMR for ischemic heart disease, while low-volume centers prioritized viability assessment. Barriers included cost, competing technologies, scanner access (developed countries), and lack of training (developing countries).

Conclusions:

• This study represents the most comprehensive global assessment of CMR practice to date.
• CMR utilization is heavily hospital-based, with adult cardiology driving referrals.
• Future efforts should expand CMR beyond academic centers, focusing on cardiomyopathy and viability assessment in community settings.