Author + information
- Lawrence M. Boxt, MD, FACC⁎ ()
- ↵⁎Division of Cardiology, North Shore University Hospital, 300 Community Drive, Manhasset, New York 11030
Dr. DeMaria’s editorial (1) on the “morphing” of cardiovascular specialists is an important contribution to the advancement of noninvasive cardiovascular imaging, as well as management of patients with cardiovascular disease. His advocacy of cardiologists acquiring radiologic imaging skills to complement their physiologic and patient management skills makes great sense and, as he suggests, will serve to provide a model for reconciliation between radiologists and cardiologists over the issue of noninvasive cardiovascular imaging. As a radiologist trained to practice cardiac magnetic resonance imaging (MRI) and computed tomography (CT), I am especially sensitive to the issue of turf, and I am usually chagrined by the simplistic approach of many leaders in both fields, namely that only we (read as either radiologists or cardiologists) can perform this service.
Part of my charge as a cardiac radiologist has been to train cardiologists in imaging science and technology, and to train radiologists in cardiac disease and cardiac imaging. I have always believed that this complementary need would smooth the way for collaboration between practitioners of both fields. Nevertheless, this has not been the case. In particular, I have found all too often that clinical and invasive cardiologists have underestimated the technical difficulties of imaging science, and radiologists have simply not been trained in cardiac medicine. I believe that technological advances in cardiac MRI did not provide impetus for such a collaboration, in part because the technology was too expensive and difficult to perform; that is, so little cardiac MRI is performed, there really is not much of a turf battle to fight. However, advances in CT image acquisition, as Dr. DeMaria notes, may provide adequate impetus to drive the change in the nature of noninvasive cardiac imaging, and thus bring about the necessary changes in the training of practitioners. Cardiology fellows can find no better teachers of the physics and clinical aspects of CT than their radiologist colleagues. There is no better way of advancing into the arena of cardiac CT than through conventional chest CT.
Furthermore, for radiologists to perform and interpret cardiac CT (and MRI) examinations, they first must be trained in the anatomy, physiology, and pathophysiology of the heart; they can find no better teachers than their cardiology colleagues. I believe that Dr. DeMaria’s call for collaboration would not only calm the tensions between radiology and cardiology, but would also produce the fertile environment needed for the growth and development of the technology and the training of future practitioners in the field.
- American College of Cardiology Foundation