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University of Iowa heart specialists using new leading-edge cardiac imaging system

IOWA CITY, Iowa -- The University of Iowa Hospitals and Clinics (UIHC) recently became one of 13 medical centers worldwide using a new, vastly improved imaging system for diagnosing patients with heart disease.

Called cardiovascular magnetic resonance imaging (CVMRI), the new technology could revolutionize cardiology worldwide within a decade, said Michael Vannier, M.D., UI professor and head of radiology and an internationally recognized expert in advanced imaging technologies.

"Iowans are very fortunate," Vannier said. "No other medical center in Iowa or its contiguous states has this system available for use and development."

CVMRI systems use a combination of advanced magnets and radio wave technology to produce real-time images of the human body (a patient's beating heart, for instance) that have the clarity of anatomy textbook illustrations.

The advanced new system being evaluated by heart specialists at the UI was developed by General Electric Medical Systems, a leading MRI manufacturer. Kevin King, general manager of Global CVMRI for GE Medical Systems, said the scanner enables clinicians at a few, select heart centers to image the heart in real-time. Images can be acquired, reconstructed, manipulated and viewed at rates as high as 15 frames per second, he said.

Before gaining full clinical acceptance, the system must undergo further refinements and trials coordinated by GE Medical Systems and imaging experts at 13 centers in the U.S. and Europe. In addition to the UI, these include the National Institutes of Health, Stanford University Medical Center, and Johns Hopkins University.

"MRI has actually been around since the early 1980s, when it was hailed as one of the greatest medical imaging breakthroughs since x-rays," Vannier said. "But early use was limited to patients with neurological and musculoskeletal diseases. Its acceptance in the field of heart disease has been much slower."

The difficulty engineers faced in imaging the heart's rapid regular movements combined with irregular, secondary motion that occurs when the patient breathes underscored this reluctance, he said. While early efforts to image the heart and coronary vessels with MRI were not unqualified successes, the obvious potential of MRI in cardiac disease fueled a vigorous research effort.

"With appropriate engineering developments, this new system will in a single image obtain all of the information we require for diagnosing patients with heart problems," Vannier said. Current practice requires one or more noninvasive diagnostic tests to detect coronary artery disease, often with inconclusive results.

"Obviously, if we can obtain conclusive evidence in a single test, it not only improves the diagnosis but also saves time, lowers patient risk and reduces costs," Vannier said. "Those are the anticipated benefits of this powerful new CVMRI system. We've been very impressed by what we've seen so far."

Within 10 years, Vannier added, virtually all major hospitals and cardiac centers will likely have a dedicated cardiovascular MRI scanner. Meanwhile, radiologists, cardiologists, biomedical engineers, and medical physicists at the UI are evaluating the new system in several research protocols.

According to the American Heart Association, more than 65 million people have some form of cardiovascular or peripheral vascular disease. Almost 5.5 million Americans have a history of heart attack, angina, or both, and 1.5 million new incidents will be reported this year. Over one million people die every year from cardiovascular disease, representing nearly 50 percent of all deaths in the U.S., more than all other diseases combined.