The Future of Cardiovascular Magnetic Resonance Imaging

Matthias G. Friedrich MD

Disclosures

Eur Heart J. 2017;38(22):1698-1701. 

In This Article

Cardiovascular Magnetic Resonance of the Future

Decades of technical developments have generated a breath-taking world of CMR techniques with gold standard level approaches for analysing morphology, function, tissue, and metabolism (see Table 2). Most of them have been extensively tested for validity, accuracy, and impact on clinical decision-making. Less and less protocols will require contrast agents as novel techniques such as mapping and dynamic OS-CMR become available. New coil concepts, such as coil system with transmit/receive functionality will significantly improve the available signal-to-noise ratio per pixel. In addition, researchers, MRI industry, and software companies are more efficiently addressing clinical workflows and cost efficiency.

Industry has realized that MRI systems are often benchmarked by their ability to perform CMR, and that the CMR markets are growing fast, with expected large-scale clinical application world-wide, especially in highly populated countries with an increase of cardiovascular disease. This will lead to more efficient, dedicated CMR system environments with largely automated image acquisition, evaluation, and reporting.

Outsourcing of image data management including image reconstruction as well as post-processing, evaluation, and interpretation will be possible through cloud-based services. This is already in practice for other imaging procedures (e.g. offshore 24/7 chest X-ray interpretation), but, especially when combined with remote expertise, will be specifically important for CMR in mid-sized and small institutions. It will be possible to store data for offline analysis in large data bases and continuous machine learning will help improving our understanding of disease and be a cornerstone in the development of novel, meaningful, and cost-efficient diagnostic approaches.

CMR is on its way to become the cardiac imaging modality for all questions not readily answered by history, physical exam, and a portable echocardiogram. Following this evolution and its positive impact on our patients is exciting and for those actively involved in the field, very gratifying.

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