Most cardiologists agree that cardiac MRI (CMR) should be the first-line imaging modality for evaluating dyspnea—yet many hospitals still treat it as a niche option or reserve tool. In U.S. health systems, where reimbursement pressures and staffing shortages influence technology decisions, CMR is often overlooked due to assumptions about its complexity or cost.
This article explores why forward-thinking organizations are disproving those assumptions and making CMR their modality of choice – and reveals what you can do to join them.
Three Reasons CMR Should Be the Modality of Choice
Making CMR more widely available will help in three primary ways:
1. Most Comprehensive Diagnostic Tool
CMR offers a greater level of sensitivity and specificity than other imaging techniques. It offers unmatched tissue characterization, superior assessment of heart function, and higher reproducibility than techniques like echocardiography – all without exposing patients to ionizing radiation.
| Research shows CMR is vital tool that enables providers to: | |
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Measure Cardiac Function: |
CMR is the gold standard for definitive quantification of LVEF and mass volume |
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Identify Viable Myocardium: |
Contrast-enhanced CMR detects dysfunction before coronary revascularization for guiding intervention |
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Rule Out Myocardial Disease: |
CMR detects cardiac involvement in 78% of post-COVID patients and ongoing inflammation in 60% – independent of preexisting conditions |
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Guide Mitral Regurgitation Decisions: |
CMR is more accurate than echocardiography in predicting outcomes and timely interventions in asymptomatic patients with severe mitral regurgitation |
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Reclassify Aortic Regurgitation Severity: |
CMR outperforms echo in quantifying AR, helping to better time valve replacement |
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Risk Stratify Pericardial Disease: |
CRM can quantify inflammation via pericardial delayed hyperenhancement to help predict recurrent pericarditis |
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Optimize ICD Placement: |
CMR accurately identifies right ventricular aneurysms and myocardial scarring, essential for arrhythmic right ventricular dysplasia assessment |
In fact, CMR is often the only method capable of reliable diagnosis. One study found that CMR identified the correct diagnosis for patients who survived sudden cardiac arrest (SCA) in more than one-third of cases where other methods were inconclusive. Similarly, CMR is the only comprehensive tool able to evaluate cardiac amyloidosis, a fatal yet treatable condition that can be found in 10-15% of patients with heart failure with preserved ejection fraction (HFpEF).
2. Avoid Unnecessary Procedures
The accuracy of CMR scans ensures the diagnostic process is as efficient as possible. One recent study found that cardiac MRI is superior to echocardiography in predicting pressure inside the heart. Nearly 71% of patients who had wrongly measured pressures by echocardiography had correct pressures by cardiac MRI. Researchers stated that these findings could reduce the need for invasive assessments, offering a more cost-effective approach while also lowering patient risk.
Other researchers have reported similar results, with one paper claiming CMR saved $2,308 per patient on average from avoiding invasive procedures, preventing additional tests and identifying new diagnoses. In a healthcare environment focused on reducing cost per diagnosis and length of stay, CMR’s accuracy can actually decrease overall cost by reducing misdiagnosis, redundant imaging, and unnecessary invasive procedures.
3. Improve Treatment Plans
CMR often corrects previous diagnoses and helps alter patients’ treatment or management plans. One review of registry data for more than 3,800 heart failure patients found that CMR led to a change in diagnosis or management in 50% of cases. For cardiology programs participating in bundled payments or aiming to reduce readmissions, that level of clinical impact is not just impressive—it’s transformative.
Equally, CMR can help tailor therapies to specific patients by providing unique information. CMR with late gadolinium enhancement (LGE) imaging for tissue characterization should be offered in every initial assessment of cardiomyopathy, as recommended in the guidelines. As a result, early diagnosis, correct risk assessment, and targeted therapy will have an impact on survival rates
As one recent paper concludes, “Instead of considering CMR as a reserve diagnostic for special cases, it will be necessary to integrate it more into everyday life.” But what will that require from organizations?
How Healthcare Providers Can Establish or Scale Cardiac MRI Programs
The U.S. is at a tipping point: demand for CMR is increasing, guidelines are shifting, and early adopters are establishing themselves as leaders in advanced cardiac imaging. Yet fewer than 2% of MRI scanners are routinely used for CMR—presenting a massive opportunity for institutions willing to modernize.
The key to implementing and scaling CMR is overcoming technologist shortages. With over 400 clicks required to set up a scan, the procedure is unusually complicated and requires specialist skills, which are in short supply. However, much of this manual effort can be eliminated using AI-driven technology that sets up and administers much of the process with automation.
Vista AI’s FDA-cleared software automates and simplifies CMR scans, reducing the skill barrier that holds back CMR adoption. Technologists of all experience levels can deliver high-quality images consistently and efficiently. Early adopters have already proven the software helps complete scans 26% faster and unlock 50% more scans for CMR.
This is the future of cardiac care: technology and human expertise combined to make CMR widely more available – and turn the gold standard into the standard of care.
Contact us to see how Vista AI can make it easier for you to adopt and scale CMR at your organization.
