We are pleased to provide below, our Inaugural ANZCMR Newsletter – a place for all things CMR!

 

In this Newsletter, we have showcased important issues for our local Australia and New Zealand landscape.

 

We also invite you to become involved in the ANZCMR Working Group and in advocating for our patients.

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Australia and New Zealand Working Group for Cardiovascular MRI

Australia and New Zealand Working Group for Cardiovascular MRI

 Providing a centralised, 

 coherent voice that 

 represents CMR 

 scientifically & politically. 

ANZCMR NEWS

 

The Official Quarterly Newsletter of ANZCMR  the working group for Cardiovascular Magnetic Resonance Imaging

JULY 2022    ISSUE 1

IN THIS ISSUE

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Message from the President

–  Professor Andrew Taylor

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Dear Reader,

 

On behalf of the ANZ CMR Working Group, it gives me great pleasure to welcome you all to the first edition of our long overdue ANZ CMR newsletter. In what we hope will be an informative quarterly update, we will keep you abreast of all the important developments in the changing landscape of CMR in Australia and New Zealand.

 

Over the last few years, we have made considerable progress in the provision of CMR services which were really accelerated by the first new Medicare item number for CMR for the evaluation of arrhythmogenic right ventricular cardiomyopathy (ARVC). Whilst initially we would have hoped for a broader range of rebateable cardiomyopathy indications for CMR, the new ARVC rebate provided an important first step for the acceptance and integration of CMR as a critical investigation in a wide range of cardiac diseases. With the help of our radiology colleagues, we have founded a conjoint committee for the certification of CMR providers, developing a bilaterally accepted (CSANZ and RANZCR) set of training standards and also developed the regulatory framework for provision of Medicare funded CMR services across Australia. This has been an outstanding achievement and I am truly grateful for all those, too many to mention individually, who contributed so much to what at times had seemed like a Sisyphean task.

 

More recently, the Working Group advocated strongly for a new item number for CMR in the assessment of vaccine associated myocarditis, leading to a temporary Medicare CMR item number for this important indication. Whilst this item number was initially only valid for CMR scans performed up to 30th June 2022, we have recently been advised that there will be some extension of this item number beyond this date. Importantly, CSANZ have just submitted a formal application for a new Medicare item number for CMR for the more general indication of myocarditis (application 1317), which is open for public consultation until July 8th. We remain hopeful of a positive response, and PASC/PICO assessment is underway with further meetings on 11th August to progress the application process.

 

In addition to its commitment to advocate for greater support of CMR as a clinical service across Australia and New Zealand, the Working Group continues to develop educational resources and promote research and training opportunities. Several of these will be highlighted in this newsletter but for a comprehensive overview I would direct you to our ANZ CMR website. Perhaps the most important to mention at this juncture is the hosting of this year’s CMR Australia conference in Melbourne 2022. After 2 years of being cruelled by COVID-19 restrictions we are delighted to be able to host this important event again and look forward to your participation.

Journal Watch Comment

–  Professor Christian Hamilton-Craig

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Seraphim et al. Quantitative Myocardial Perfusion Predicts Outcomes in Patients With Prior Surgical Revascularization

J Am Coll Cardiol. 2022 Mar, 79 (12) 1141–1151

https://www.jacc.org/doi/full/10.1016/j.jacc.2021.12.037

 

Stress perfusion CMR using adenosine as a vasodilator stressor is a well-established technique for the imaging of myocardial perfusion, but has poor uptake in Australia due to lack of reimbursement, as well as lack of experienced operators trained in the technique.

 

There have been a number of large-scale randomized clinical trials which have shown the diagnostic accuracy, comparative efficacy, health economics, and prognostic data derived from Stress-CMR. Compared to the gold standard invasive fractional flow reserve (FFR), stress CMR with adenosine has a high sensitivity of 91% and specificity of 94% for identification of lesion-specific ischemia.

 

Until recently, visual analysis of grey-scale images is the main, subjective method for analysing Stress-CMR. Recently, new pixel-wise quantitative mapping techniques have emerged for the automated, in-line quantitation of myocardial perfusion using adenosine Stress CMR.

 

Stress CMR with AI multi-layer convolution neural network with in-line delineation of the left ventricle cavity and myocardium, excluding myocardial fat and papillary muscles, without any human interaction with the image data (figure below).

 

Seraphim et al (JACC 2022) evaluated whether global stress myocardial blood flow (MBF) and perfusion reserve (MPR) derived from perfusion mapping cardiac magnetic resonance (CMR) independently predict adverse outcomes in patients with prior CABG. They found that global stress MBF and MPR derived from perfusion CMR independently predict adverse outcomes in patients with previous CABG, and this effect was independent from the presence of regional ischemia on visual assessment, and also the extent of previous infarction seen on LGE imaging.

 

This shows that Stress CMR is valid in patients post-CABG, and the in-line quantitative perfusion mapping improves assessment and prognostic value of Stress CMR.

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Meet the ANZCMR Board

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President

Professor Andrew Taylor

Cardiologist and Director of Cardiac MRI

 

Department of Cardiology, Alfred Hospital, Melbourne

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Vice-President

Dr Rebecca Kozor

Cardiologist, Royal North Shore Hospital, Sydney

 

Senior Lecturer, University of Sydney

 

Co-Director of the University of Sydney CMR Group

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Treasurer

Dr Preeti Choudhary

Cardiologist and specialist in cardiac MRI and adult congenital heart disease at Westmead, Blacktown and Auburn hospitals

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Scientic Secretary

Professor Martin Ugander

Professor of Cardiac Imaging, University of Sydney

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Immediate Past-President

Dr John Younger

Cardiologist, Royal Brisbane and Women's Hospital, Brisbane

 

University of Queensland

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RANZCR / CSANZ / ANZCMR Conjoint Committee

Professor Christian Hamilton-Craig

Director, Noosa Hearts Cardiology

 

Professor, University of Queensland Faculty of Medicine & Centre for Advanced Imaging

 
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Call for Nominations for State Representatives

We are looking for an individual to represent each state in Australia and two representatives from New Zealand.

You will be the link between the ANZCMR team and other CMR clinicians within your region.

Please email treasurer@anzcmr.org.au with your CV and any questions you may have.

Submissions close 31 August 2022.

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2022 CMR AUSTRALIA MASTERCLASS

 

Date

 

Saturday 

12th November 2022

8.30am - 4.00 pm

Location

 

Alfred Hospital Innovation and Education Hub

 

Alfred Precinct

75 Commercial Road

Melbourne  VIC  3004

ALTERNATIVE:   Webinar via Zoom

Masterclass Registration Fees

IN PERSON ATTENDEE

(maximum 200)

includes 12-month ANZCMR membership

$150

ALTERNATIVE

WEBINAR VIA ZOOM

includes 12-month ANZCMR membership

$120

MSAC Application 1713

Cardiac MRI in the Diagnosis of Myocarditis

The Cardiac Society of Australia and New Zealand (CSANZ), together with Australia and New Zealand Working Group for MRI, have submitted an application for a new MBS item number for 'Cardiac MRI in the Diagnosis of Myocarditis'.

 

As part of the appraisal process, the Medical Services Advisory Committee (MSAC) invited input on the application from a range of stakeholders, through both targeted and public consultation which closed on 8th July.

 

The society of cardiovascular magnetic resonance (SCMR) submitted an application of support, along with the cardiac society and multiple stakeholders.
 

The next step is a PASC meeting for this application, scheduled for 11 August 2022.

http://www.msac.gov.au/internet/msac/publishing.nsf/Content/1713-public

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