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Nuclear cardiology news update
JOURNAL OF NUCLEAR CARDIOLOGY NUCLEAR CARDIOLOGY NEWS UPDATE ASNC NEWS The recent meeting of the American Heart Association in Dallas, Texas (November 1994), was busy but rewarding for the ASNC Executive Council and ASNC Committees. ASNC is clearly maturing and delivering on its promises. A number of important results were presented, and significant decisions concerning the future of nuclear cardiology were made. The following is a short summary of the principal ASNC proceedings during the A H A meeting. International Council. The background for proposing an International Council was discussed in "Message from the President" in the December 1994 ASNC Newsletter. The ASNC Board of Directors approved in Dallas the institution of the International Council. In a subsequent meeting with representatives of nine countries, it was decided that countries with an official affiliation with ASNC may appoint one or two national delegates. When two delegates are appointed, one must represent cardiology and the other nuclear medicine/radiology. When only one national delegate is appointed, that person should represent an integrated (cardiology and nuclear medicine/radiology) national working group or society in nuclear cardiology. Each delegate to the International Council will have a single vote. The chairman (to be determined) will be a non-US ASNC member. Corporate Council. An ASNC Corporate Council, consisting of founding industrial benefactors and sponsors and the ASNC Executive Council, was recently instituted to enhance collaboration between ASNC and industry on issues in nuclear cardiology of mutual interest and importance. An important first decision by the Corporate Council was to initiate a joint marketing plan to promote nuclear cardiology as a product. ASNC trusts that the Corporate Council will become an invaluable ongoing partnership. Certification in Nuclear Cardiology. Within the rapidly changing environment of managed health care, it will be important to define who is qualified to provide nuclear cardiology services and who is not. Although training in nuclear cardiology is now well defined, the required qualifications for the practicing nuclear cardiologists are not. It is crucial for the future of nuclear cardiology that certification or accreditation to insure quality be established. The ASNC Board of Directors approved that the Executive Council and an Ad Hoc Committee on Credentialing in Nuclear Cardiology explore the feasibility of accreditation and/or certification of laboratories and persons in nuclear cardiology. The Executive Council hopes to report before, or at, the Annual ASNC Membership Meeting in March 1995 on this important issue. JOURNALOFNUCLEARCARDIOLOGY January/February 1995
National Nuclear Cardiology Database. The Health Care Policy Committee has been working on a proposal for a cooperative project on perfusion imaging. The goal of this project is to generate published data that will demonstrate the use of myocardial perfusion imaging as a replacement for, or supplement to, treadmill exercise testing at specific "nodal" points in emerging clinical practice guidelines, where recommendations will be made with respect to cardiac catheterization and revascularization. The plan proposes to combine several existing institutional nuclear cardiology databases and perform cooperative data analyses in much larger numbers of patients than was previously possible. Application for Continuing Medical Education (CME) Credits. The ASNC Staff in the Bethesda office is in the middle of the process of composing an application to the American Council for Continuing Medical Education for CME credits. This will be of considerable importance for the many educational efforts that ASNC undertakes. JOURNALOFNuctt~ CAAOIOLOGYin Index Medicus. The publisher of the JOURNALOF NUCLEARCARDIOLOGY,Mosby, is in the process of applying for inclusion in the Index Medicus of the articles published in the JOURNAL. Training Guidelines In Nuclear Cardiology and Guidelines for Clinical Use of Cardiac Radionuclide Imaging. The Joint ACC/ASNC Guidelines for Training in Nuclear Cardiology have been approved by the Board of Directors of ASNC and by the Board of Trustees of the American College of Cardiology. These guidelines will be published simultaneously in the Journal of the American College of Cardiology and JOURNALOe NUCLEAR CARDIOLOGY. Similarly, the Guidelines for Clinical Use of Cardiac Radionuclide Imaging have been approved by the ASNC Board of Directors. These guidelines will be published in the JOURNALas well. Slate of Nominees for ASNC Offices. The ASNC Nominating Committee proposed the following slate to the Board of Directors for nomination at the Annual Membership Meeting in March 1995: President: Ami E. Iskandrian; President-elect: Mario Verani; Vice President: Raymond J. Gibbons; Secretary: Manuel D. Cerqueira; Treasurer: Kenneth Brown; Board of Directors: Elias H. Botvinick, D. Douglas Miller, Heinz Sochor, H. William Strauss. The Board of Directors voted unanimously in favor of the proposed slate. Frans J. Th. Wackers, MD President
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96
News update
JOURNALOF NUCLEARCARDIOLOGY January/February 1995
INTERNATIONAL NEWS Argentina. In October 1994, the Argentine College of Nuclear Cardiology was officially created. The meeting was attended by more than 50 nuclear cardiologists. An Executive Board was elected, as follows: President: Nestor Vita; Vice President: Cesar Belziti; Secretary: Victor Balestrini; Vice Secretary: Manuel Leucowitz; Treasurer: Osvaldi Masoli; Vice Treasurer: Guillermo Covelli; and Board of Directors: Daniel Cragnolino, Anibal Mele, Presti Cecilia. Our next meeting is scheduled for May 25 to 27, 1995, in Parana; we are expecting nuclear cardiologists from Uruguay, Brazil, and Chile. At the same time, an international symposium will take place. We do hope this will be a good opportunity to promote nuclear cardiology in our country. Nestor A. Vita, MD
Australia. Clinical cardiac studies are currently performed in the two cyclotron PET centers situated in Sydney and Melbourne, both located within university medical centers with tertiary referral academic cardiology departments that have interventional and surgical facilities. Both have patients referred on a broad statewide basis. Studies are mainly for assessing myocardial viability using resting ammonia and FDG imaging in selected patients who satisfy detailed eligibility criteria. Some coronary flow reserve studies with rest/dipyridamole ammonia imaging are also performed. PET is being increasingly used in clinical decisionmaking alongside 2~ and other investigations, but there is no reimbursement by either the national health insurance system or third party insurers. Cardiac patients share access to PET resources with other clinical patients in neurology and oncology, as well as with the range of research subjects. Kevin C. Allman, MD Chile. The Iberoamerican Society of Nuclear Cardiology was established after the Iberoamerican Symposium of Nuclear Cardiology (Pucon, Chile, October 2-5, 1994). This Society is meant to integrate all the members of the different Iberoamerican countries who are active in research or do practical work in nuclear cardiology; we expect to develop guidelines and quality standards. A meeting will be held every 2 years; the next one will be in Pucon in October 1996. The board of directors will be comprised of two members from each country. For further information regarding the activities of the Society, please contact Dr. Enrique Olea, Nuclear Medicine, Catholic University, Marcoleta 347, Santiago, Chile (56-2-638-1802, 56-2-6333266 fax). Enrique Olea, MD Germany. The XIIth World Congress of Cardiology and the XVIth Congress of the European Society" of Cardiology were held in Berlin in September 1994 and were very successful, with more than 14,000 active participants. The Working Group on Nuclear Cardiology and Magnetic Resonance Imaging organized three symposia: (1) "Diag-
nostic Methods Towards the Year 2000" was co-organized together with the International Society and Federation of Cardiology (ISFC) Scientific Council on Clinical Cardiology and featured an update on modern cardiac functional and metabolic imaging. (2) The ISFC Scientific Council on Clinical Cardiology and the ESC Working Group on Exercise Physiology, Physiopathology and Electrocardiography cosponsored "Choosing the Proper Stress Technique." (3) "Assessment and Prognosis of Left Ventricular Hypertrophy" was also co-organized with the Council of Clinical Cardiology of the ISFC. All three symposia were well attended and featured state-of-the-art overviews by speakers from all over the world. On the organizational side, Udo Sechtem (Cologne, Germany) succeeded Heinz Sochor (Vienna, Austria) as chairman of the Working Group on Nuclear Cardiology and Magnetic Resonance Imaging. Richard Underwood (London) became the new vice chairman; Alberto Righetti (Geneva, Switzerland) remained the treasurer; and Frank Baer (Cologne, Germany) is the new secretary. Over the next 2 years, the working group will attempt to achieve more scientific collaboration among its members and attract younger scientists interested in nuclear cardiology and magnetic resonance techniques. One way to achieve this goal is the creation of travel grants for young scientists that will enable them to visit other centers of research within Europe. Such visits should strengthen personal relationships and provide an opportunity to learn new techniques. Other activities will include the creation of both a newsletter and a database containing the publications and current research interests of the members of the working group. The working group also intends to strengthen its collaboration with European national working groups on nuclear cardiology and magnetic resonance. Dr. Sechtem underscored the importance of an intense collaboration with the European Association of Nuclear Medicine (EANM) and the American Society of Nuclear Cardiology (ASNC). Two courses will be organized in 1995 by members of the working group at the new European Heart House near Nice, in the south of France. The first, a workshop on "Cardiovascular Magnetic Resonance Techniques: Clinical and Scientific Applications," will take place May 18 to 20. The program includes teaching of basic physics and technical aspects that are targeted to a clinical audience, as well as lectures on clinical applications. Special emphasis will be put on workshops featuring the presentation and discussion of individual cases in small groups. The second course, "Nuclear Cardiology," is being put together by Dr. van der Wall of Amsterdam and Prof. Sochor of Vienna. This course is aimed mainly at cardiologists. It will provide basic knowledge on cardiovascular nuclear imaging and discuss imaging strategies for various clinical situations with an emphasis on the comparison of the competing imaging modalities. The European Heart House features a large variety of education and training programs. A booklet containing information on all its activities can be obtained from
JOURNAL OF NUCLEAR CARDIOLOGY
News update
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Volume 2, Number 1;95-7 ECOR, European Heart House, 20-35 Route de Colles, Les Templiers-BP 179, 06903 Sophia Antipolis, Cedex, France (33-92-947-600, 33-92-947-601 fax).
Udo P. Secthem, MD Italy. The so-called SIRT study (Italian Study on Thallium Reinjection) is probably the most multicenter effort going on now. Nearly 400 patients (almost all with a history of myocardial infarction) have been enrolled in this study at 12 Italian centers that are all equipped with the same type of gamma cameras. All patients have had planar studies with thallium reinjection; one group was reinjected the same day, and another group on a different day. The aim was to verify the incidence of reversibility with reinjection of fixed defects at traditional redistribution. Data of interobserver variability of planar thallium imaging from SIRT has already been published (J Nucl Med 1994;35:601-8). The results of
the incidence of reversibility with reinjection of fixed defects at redistribution is in press (J Nucl Med). The follow-up data collection is finished. The analysis will be ready in 2 to 3 months. The monitor of the study is Dr. Eugenio Inglese, Chief of the Nuclear Medicine Service in Novara Hospital (++ 39 321 373547 fax). The Italian Group is actively working on a project of Dr. Raffaele Giubbini (Brescia) aimed at organizing a multicenter commission to perform periodic quality control of nuclear cardiology examinations. Finally, the updated version of the handbook manual "Standardization of Cardiological Examinations in Nuclear Medicine" (written in Italian) is completed. It provides detailed information on how to perform the examinations. Copies can be obtained through the Italian Association of Nuclear Medicine, Via S. Antonio 32, CP 115, 56123 Pisa.
Gianfranco Mazzotta, MD
National Nuclear Cardiology Database. The Health Care Policy Committee has been working on a proposal for a cooperative project on perfusion imaging. The goal of this project is to generate published data that will demonstrate the use of myocardial perfusion imaging as a replacement for, or supplement to, treadmill exercise testing at specific "nodal" points in emerging clinical practice guidelines, where recommendations will be made with respect to cardiac catheterization and revascularization. The plan proposes to combine several existing institutional nuclear cardiology databases and perform cooperative data analyses in much larger numbers of patients than was previously possible. Application for Continuing Medical Education (CME) Credits. The ASNC Staff in the Bethesda office is in the middle of the process of composing an application to the American Council for Continuing Medical Education for CME credits. This will be of considerable importance for the many educational efforts that ASNC undertakes. JOURNALOFNuctt~ CAAOIOLOGYin Index Medicus. The publisher of the JOURNALOF NUCLEARCARDIOLOGY,Mosby, is in the process of applying for inclusion in the Index Medicus of the articles published in the JOURNAL. Training Guidelines In Nuclear Cardiology and Guidelines for Clinical Use of Cardiac Radionuclide Imaging. The Joint ACC/ASNC Guidelines for Training in Nuclear Cardiology have been approved by the Board of Directors of ASNC and by the Board of Trustees of the American College of Cardiology. These guidelines will be published simultaneously in the Journal of the American College of Cardiology and JOURNALOe NUCLEAR CARDIOLOGY. Similarly, the Guidelines for Clinical Use of Cardiac Radionuclide Imaging have been approved by the ASNC Board of Directors. These guidelines will be published in the JOURNALas well. Slate of Nominees for ASNC Offices. The ASNC Nominating Committee proposed the following slate to the Board of Directors for nomination at the Annual Membership Meeting in March 1995: President: Ami E. Iskandrian; President-elect: Mario Verani; Vice President: Raymond J. Gibbons; Secretary: Manuel D. Cerqueira; Treasurer: Kenneth Brown; Board of Directors: Elias H. Botvinick, D. Douglas Miller, Heinz Sochor, H. William Strauss. The Board of Directors voted unanimously in favor of the proposed slate. Frans J. Th. Wackers, MD President
95
96
News update
JOURNALOF NUCLEARCARDIOLOGY January/February 1995
INTERNATIONAL NEWS Argentina. In October 1994, the Argentine College of Nuclear Cardiology was officially created. The meeting was attended by more than 50 nuclear cardiologists. An Executive Board was elected, as follows: President: Nestor Vita; Vice President: Cesar Belziti; Secretary: Victor Balestrini; Vice Secretary: Manuel Leucowitz; Treasurer: Osvaldi Masoli; Vice Treasurer: Guillermo Covelli; and Board of Directors: Daniel Cragnolino, Anibal Mele, Presti Cecilia. Our next meeting is scheduled for May 25 to 27, 1995, in Parana; we are expecting nuclear cardiologists from Uruguay, Brazil, and Chile. At the same time, an international symposium will take place. We do hope this will be a good opportunity to promote nuclear cardiology in our country. Nestor A. Vita, MD
Australia. Clinical cardiac studies are currently performed in the two cyclotron PET centers situated in Sydney and Melbourne, both located within university medical centers with tertiary referral academic cardiology departments that have interventional and surgical facilities. Both have patients referred on a broad statewide basis. Studies are mainly for assessing myocardial viability using resting ammonia and FDG imaging in selected patients who satisfy detailed eligibility criteria. Some coronary flow reserve studies with rest/dipyridamole ammonia imaging are also performed. PET is being increasingly used in clinical decisionmaking alongside 2~ and other investigations, but there is no reimbursement by either the national health insurance system or third party insurers. Cardiac patients share access to PET resources with other clinical patients in neurology and oncology, as well as with the range of research subjects. Kevin C. Allman, MD Chile. The Iberoamerican Society of Nuclear Cardiology was established after the Iberoamerican Symposium of Nuclear Cardiology (Pucon, Chile, October 2-5, 1994). This Society is meant to integrate all the members of the different Iberoamerican countries who are active in research or do practical work in nuclear cardiology; we expect to develop guidelines and quality standards. A meeting will be held every 2 years; the next one will be in Pucon in October 1996. The board of directors will be comprised of two members from each country. For further information regarding the activities of the Society, please contact Dr. Enrique Olea, Nuclear Medicine, Catholic University, Marcoleta 347, Santiago, Chile (56-2-638-1802, 56-2-6333266 fax). Enrique Olea, MD Germany. The XIIth World Congress of Cardiology and the XVIth Congress of the European Society" of Cardiology were held in Berlin in September 1994 and were very successful, with more than 14,000 active participants. The Working Group on Nuclear Cardiology and Magnetic Resonance Imaging organized three symposia: (1) "Diag-
nostic Methods Towards the Year 2000" was co-organized together with the International Society and Federation of Cardiology (ISFC) Scientific Council on Clinical Cardiology and featured an update on modern cardiac functional and metabolic imaging. (2) The ISFC Scientific Council on Clinical Cardiology and the ESC Working Group on Exercise Physiology, Physiopathology and Electrocardiography cosponsored "Choosing the Proper Stress Technique." (3) "Assessment and Prognosis of Left Ventricular Hypertrophy" was also co-organized with the Council of Clinical Cardiology of the ISFC. All three symposia were well attended and featured state-of-the-art overviews by speakers from all over the world. On the organizational side, Udo Sechtem (Cologne, Germany) succeeded Heinz Sochor (Vienna, Austria) as chairman of the Working Group on Nuclear Cardiology and Magnetic Resonance Imaging. Richard Underwood (London) became the new vice chairman; Alberto Righetti (Geneva, Switzerland) remained the treasurer; and Frank Baer (Cologne, Germany) is the new secretary. Over the next 2 years, the working group will attempt to achieve more scientific collaboration among its members and attract younger scientists interested in nuclear cardiology and magnetic resonance techniques. One way to achieve this goal is the creation of travel grants for young scientists that will enable them to visit other centers of research within Europe. Such visits should strengthen personal relationships and provide an opportunity to learn new techniques. Other activities will include the creation of both a newsletter and a database containing the publications and current research interests of the members of the working group. The working group also intends to strengthen its collaboration with European national working groups on nuclear cardiology and magnetic resonance. Dr. Sechtem underscored the importance of an intense collaboration with the European Association of Nuclear Medicine (EANM) and the American Society of Nuclear Cardiology (ASNC). Two courses will be organized in 1995 by members of the working group at the new European Heart House near Nice, in the south of France. The first, a workshop on "Cardiovascular Magnetic Resonance Techniques: Clinical and Scientific Applications," will take place May 18 to 20. The program includes teaching of basic physics and technical aspects that are targeted to a clinical audience, as well as lectures on clinical applications. Special emphasis will be put on workshops featuring the presentation and discussion of individual cases in small groups. The second course, "Nuclear Cardiology," is being put together by Dr. van der Wall of Amsterdam and Prof. Sochor of Vienna. This course is aimed mainly at cardiologists. It will provide basic knowledge on cardiovascular nuclear imaging and discuss imaging strategies for various clinical situations with an emphasis on the comparison of the competing imaging modalities. The European Heart House features a large variety of education and training programs. A booklet containing information on all its activities can be obtained from
JOURNAL OF NUCLEAR CARDIOLOGY
News update
97
Volume 2, Number 1;95-7 ECOR, European Heart House, 20-35 Route de Colles, Les Templiers-BP 179, 06903 Sophia Antipolis, Cedex, France (33-92-947-600, 33-92-947-601 fax).
Udo P. Secthem, MD Italy. The so-called SIRT study (Italian Study on Thallium Reinjection) is probably the most multicenter effort going on now. Nearly 400 patients (almost all with a history of myocardial infarction) have been enrolled in this study at 12 Italian centers that are all equipped with the same type of gamma cameras. All patients have had planar studies with thallium reinjection; one group was reinjected the same day, and another group on a different day. The aim was to verify the incidence of reversibility with reinjection of fixed defects at traditional redistribution. Data of interobserver variability of planar thallium imaging from SIRT has already been published (J Nucl Med 1994;35:601-8). The results of
the incidence of reversibility with reinjection of fixed defects at redistribution is in press (J Nucl Med). The follow-up data collection is finished. The analysis will be ready in 2 to 3 months. The monitor of the study is Dr. Eugenio Inglese, Chief of the Nuclear Medicine Service in Novara Hospital (++ 39 321 373547 fax). The Italian Group is actively working on a project of Dr. Raffaele Giubbini (Brescia) aimed at organizing a multicenter commission to perform periodic quality control of nuclear cardiology examinations. Finally, the updated version of the handbook manual "Standardization of Cardiological Examinations in Nuclear Medicine" (written in Italian) is completed. It provides detailed information on how to perform the examinations. Copies can be obtained through the Italian Association of Nuclear Medicine, Via S. Antonio 32, CP 115, 56123 Pisa.
Gianfranco Mazzotta, MD