Novel Techniques in Imaging Congenital Heart Disease: JACC Scientific Statement (JACC January 2024-1)-Article: Novel Techniques in Imaging Congenital Heart Disease

Article: Novel Techniques in Imaging Congenital Heart Disease

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Advancements in cardiac imaging technologies have greatly improved the diagnosis and treatment of patients with congenital heart disease (CHD). Techniques such as 3D imaging, computational fluid dynamics (CFD), fusion imaging, interventional cardiac magnetic resonance (CMR) imaging, and digital twin technology are playing a crucial role in this field.<br /><br />The use of 3D imaging has allowed for better visualization and planning of surgeries and interventions. It involves the reconstruction of 3D models from various imaging modalities, such as echocardiography, CMR, CT, and angiography. These models are used to predict post-intervention outcomes and guide interventional procedures. Machine learning has also been implemented to improve computational speed and accuracy.<br /><br />Fusion imaging combines 3D reconstructions with live fluoroscopy, reducing radiation exposure and improving procedural guidance. This technology enhances the accuracy and safety of interventions.<br /><br />Interventional CMR imaging offers real-time visualization without the use of radiation. Although challenges such as radiofrequency-induced heating and limited visibility of standard catheters have been obstacles, advancements in MR-conditional equipment and low-field scanners are showing promise.<br /><br />Digital twin technology creates anatomic digital twins from segmented imaging data. These twins can be 3D printed or displayed digitally to aid in surgical planning, medical device anatomic overlay, and virtual procedural planning.<br /><br />AI is being incorporated into image analysis and reconstruction, improving efficiency and accuracy. Radiation reduction protocols are also being developed to reduce the risks associated with repeated imaging.<br /><br />The integration of 3D imaging into clinical care pathways is improving the overall management of CHD patients. However, further research is needed to validate the clinical value and cost-effectiveness of these advancements, and education and training are necessary to ensure widespread implementation.<br /><br />Overall, the advancements in cardiac imaging technologies are revolutionizing the assessment and treatment of patients with CHD, providing better visualization, improved procedural guidance, and more accurate diagnoses.

Keywords

cardiac imaging technologies

congenital heart disease

3D imaging

computational fluid dynamics

fusion imaging

interventional cardiac magnetic resonance imaging

digital twin technology

machine learning

radiation reduction protocols

clinical care pathways