Heart failure (HF) affects approximately 6.7 million Americans over the age of 20—a number projected to increase by 30% by 2030. The lifetime risk of developing HF has risen to 24%, meaning about 1 in 4 individuals will experience heart failure at some point in their lives.
Cardiac magnetic resonance imaging (CMR), or cardiac MRI, is the most comprehensive and radiation-free way to evaluate the heart’s structure and function with its superior image quality, soft tissue contrast, and volumetric acquisition format. CMR has demonstrated superior quantification of major underlying conditions that can lead to heart failure such as myocardial ischemia, cardiomyopathy, and valvular disease.
Despite its advanced capabilities, most cardiology patients lack access to CMR, which can lead to uncertain diagnoses and delayed treatment.
Why CMR is the Gold Standard for Cardiac Imaging
Cardiac imaging—especially echocardiography—has significantly enhanced the accuracy of diagnosing and treating heart conditions, and its increased use correlates with improved patient outcomes.
However, 10-15% of echocardiographic images are considered technically difficult, which can lead to uninterpretable studies. Ongoing issues around image quality and subjective assessments remain due to operator variability, patient habitus, and inherent ultrasound limitations.
With its excellent image quality, expanded diagnostic repertoire, and quantitative accuracy, Cardiac MRI has the most comprehensive imaging capabilities for assessing the heart. A Cardiac Failure Review article on Novel Imaging Techniques for Heart Failure states, “The high spatial and temporal resolution of CMR makes it suitable for use in the assessment of right (RV) and LV, providing a comprehensive study that includes anatomical evaluation, functional data and great information about myocardial perfusion and viability.”
Studies have demonstrated multiple ways CMR leads to notable benefits:
- Better Diagnostic Accuracy in Technically Difficult Echo Patients: A study comparing difficult-to-image patients, cardiac MRI visualized heart function in 100% of patients vs. 60% of patients with echo.
- Improved Diagnostic Accuracy for HFpEF: Over 60% of heart failure patients are affected by HFpEF and 10-15% potentially have cardiac amyloidosis – CMR is the only comprehensive tool to evaluate this fatal but treatable condition.
- Reduced Care Costs: Some researchers have found CMR led to a “drastic change” to care plans in 25% of cases. Providers were able to avoid unnecessary invasive procedures, identify more effective treatment plans, and reduce the cost of care to $2,308 per patient compared to the current standard of care.
This helps explain why the usage of CMR has more than doubled in the last decade. However, given that just 1% of cardiac imaging falls under the classification of CMR, this still means the vast majority of patients miss out on the most comprehensive scans.
The Complexity of CMR Imaging and Its Dependence on Skilled Technologists
Unlike other imaging modalities, CMR requires intricate protocols to acquire high-quality diagnostic images. Each scan demands hundreds of manual interactions—from parameter adjustments to positioning decisions. These complex protocols are labor-intensive and prone to variability, resulting in unpredictable scan times that can take 60-90 minutes.
Even within the same institution, different technologists may produce slightly different results, affecting consistency, interpretation, and efficiency. Minor inconsistencies can impact scan duration and image quality, influencing diagnostic confidence and patient care.
MRI Technologist Shortages is a Pervasive Problem in the US
A key challenge is the reliance on highly trained technologists to ensure consistent execution. These professionals possess deep expertise in operating MRI systems, selecting protocols, and troubleshooting in real time. However, their availability is increasingly constrained due to workforce shortages, burnout, and growing patient volumes.
There is an 18.1% shortage of MRI technologists and radiologists. These shortages are exacerbated by the limited availability of training, with just 7% of ACR-accredited sites offering further accreditation in CMR. This means MRI technologists looking to develop the necessary skills may be held back by geographical limitations.
Furthermore, with demand rising and shortages looming, technologists are asked to do more with less, leading to significant burnout and an average annual technologist turnover rate of 17.5%.
Due to these challenges, CMR scans are restricted to well-resourced institutions, leaving a large geographical variance in the availability of CMR scans and causing millions of patients to miss out on life-saving imaging.
But these issues also impact sites that do offer CMR scans. With wait times spanning 2 weeks to 3 months and large, growing backlogs, patients fortunate enough to have access to CMR scans are left waiting for results – creating anxiety and potentially delaying care.
This has created a huge demand for a different way of administering scans, which would enable more sites to start programs or scale their CMR programs, eliminate backlogs, and improve patient care. However, only recently has a solution emerged that addresses the true root of the issue: manual processes that place a heavy demand on technologists.
Embracing Automation and AI in CMR
To address these issues, many imaging departments are turning to automation and artificial intelligence (AI). AI-driven solutions can streamline workflows by reducing manual steps and enhancing scan quality and consistency. These innovations support technologists in delivering reliable, high-quality imaging, ultimately improving efficiency, patient throughput, and overall outcomes.
Leading the Transformation with AI-Driven CMR
Vista.ai is at the forefront of this revolution, providing cutting-edge AI-powered solutions that automate and simplify CMR scanning. Its FDA-cleared Vista Cardiac software automates the tedious tasks required of an expert technologist to perform a CMR scan – from scan planning
and localization to parameter tuning to real-time motion and artifact detection and in-line analysis.
This empowers technologists of all experience levels to complete complex scans quickly, accurately and with consistency. By integrating Vista.ai’s technology, Brigham and Women’s Hospital was able to minimize variability, overcome workforce limitations, and deliver more reliable, efficient patient care without extra MRI scanners, hours or personnel:
- Complete CMR scans 26% faster
- Unlock 50% more scan slots, enabling 900 more scans
- Reduce wait times from 1 month to 1 day
Want to explore how Vista.ai could help you produce similar results?
