The yearly message from ASNC President, Dr. Mouaz H. Al-Mallah, was crystal clear: nuclear cardiology labs must modernize. While the sentiment rings true for most cardiologists, the path to modernization is less obvious.

The pressing reality is that many labs still rely on 10- or even 20-year-old cameras for imaging. While the hardware, if properly maintained, is still viable, the software and operating system will likely need to be updated to meet today’s evolving networking security concerns and requirements.

Modernization will necessitate proactive action from your staff and a level of financial investment. The good news? A range of options exists for modernizing your lab—from simple upgrades to adding new equipment and modalities. Having a roadmap will help you plan effectively for the future.

1. Upgrade Your SPECT Imaging Hardware Equipment

For most cardiology labs, their SPECT camera is the go-to tool for cardiac imaging and diagnostics. Because of its central role, modernization efforts often start here, especially if you’re working with a camera that’s over a decade old or shows signs of frequent downtime.

Key Indicators for an upgrade include:

  • Frequent system failures
  • Extended repair times
  • Equipment age surpassing 10 years
  • The camera is nearing the seven-year resale value “sweet spot”
  • Networking challenges and security concerns especially considering HIPAA requirements

Recent advancements in SPECT technology offer compelling reasons to upgrade. Newer models are more compact, faster, and deliver superior image quality. Consider making the switch to a Solid-State camera using CzT or CsI to take your performance to the next level. The Digirad Cardius 3, for example, offers a smaller footprint, options for low-dose imaging, and improved image quality for high-BMI patients.

Another option would be to upgrade to a system that performs Attenuation Correction. SPECT/CT systems or the X-ACT+ both provide attenuation correction, which can improve both the sensitivity and specificity of the scan.

Upgrading usually includes warranty coverage, reduced downtime, and a more predictably reliable operation. Investing in a SPECT camera upgrade is not just an expenditure—it’s a strategic move for your lab’s future, blending quality patient care with operational efficiency.

2. Upgrade Your Software

Improving existing systems through software upgrades can be a cost-effective route to modernization.

All systems can benefit by upgrading their OS to Windows 10 as well as investing in the newest WIN10-based acquisition or processing packages. Outdated systems pose a security risk and create incompatibility issues, making this a foundational aspect of any modernization effort. Likewise, SPECT systems can improve their images and interpretations by upgrading to the newest cardiac software packages from companies like Cedars Sinai, INVIA, or Syntermed.

Upgrading your PACS can also facilitate better communication with referring physicians and can be a crucial step in meeting upcoming Appropriate Use Criteria standards. Leveraging a modern PACS system will enhance the security of patient information and ensure that your systems are compatible with newer technologies, facilitating easier upgrades in the future.

Additionally, one basic but critical step is to ensure that all your devices and equipment are running up-to-date operating systems, such as Windows 10. Outdated systems can pose a security risk and create incompatibility issues, making this a foundational aspect of any modernization effort.

By adopting a comprehensive approach to software upgrades, you’re not just enhancing the performance and capabilities of your imaging systems, but also ensuring that your practice operates within the bounds of healthcare compliance and with the highest standards of data security.

3. Expand to Offer PET/CT Imaging Services

For practices that have already modernized their SPECT imaging and software, the next frontier could be the addition of PET/CT services. The adoption of PET in cardiology is expected to grow significantly over the next decade. Advantages include higher quality images, lower radiation doses for patients, and higher reimbursements.

Importantly, a PET/CT scanner also enables your practice to offer a wide range of new tests that aren’t possible with a standard SPECT camera. Tests such as Myocardial Blood Flow, Myocardial Flow Reserve, and Cardiac Amyloidosis could add a new dimension to your imaging and diagnostic services.

While costs have historically been prohibitive, innovations in radiopharmaceuticals and the increased availability of high-quality refurbished systems are making PET more accessible. Before making the leap into PET/CT, it’s crucial to conduct a thorough evaluation of whether this technology will align with your practice’s needs and capabilities.

Companies such as TTG Imaging Solutions can help you assess if offering PET/CT imaging aligns well with your current SPECT imaging volumes and other factors. Additionally, it’s wise to request a pro forma from your vendor before purchasing a PET/CT scanner. A pro forma will give you a detailed financial outlook, allowing you to see if adding this technology would be a good fit for your practice financially.

4. Utilize AI Technology with Your Current Equipment

Artificial Intelligence (AI) technology is an emerging area of modernization that cardiologists are actively exploring. The primary advantage of integrating AI into your cardiology practice is its ability to take standard SPECT scans and enhance them intelligently through specialized software algorithms.

This isn’t just theoretical; technology exists today that can compare your scans with thousands of similar cases, allowing for intelligent adjustments that significantly improve image quality.

What makes this even more compelling is that these enhancements are available without having to upgrade your existing equipment. In particular, advanced features like Attenuation Correction can now be added directly to your standard SPECT MPI scans via AI algorithms.

But the promise of AI doesn’t stop there. Upcoming technology will enable the measurement of myocardial blood flow using a standard SPECT camera. This capability opens new avenues for diagnosis and treatment, making it a potential game-changer for your practice. In essence, adopting AI technologies offers a clear and cost-effective pathway to modernize your lab, allowing you to offer higher quality imaging services without significant hardware investments.

Now is The Time for Action

The words of Dr. Mouaz H. Al-Mallah encapsulate the urgency: “Modernizing our labs and utilizing the newest technologies in our daily practice is not an option, but rather a mandate.” Staying ahead in the field of nuclear cardiology requires timely action.

Whether you choose to upgrade your SPECT camera, enhance your software, expand into PET/CT, or adopt AI technologies, the imperative is clear: start planning now.

Waiting until your outdated system breaks can be a costly mistake. The time for modernization is now; take proactive steps to ensure your practice remains at the forefront of nuclear cardiology.