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What is multimodality cardiovascular imaging and how can it be delivered?
  1. Chaitanya Madamanchi1,
  2. Marcelo F Di Carli2,
  3. Ron Blankstein2
  1. 1 Departments of Medicine (Cardiovascular Division) and Radiology, University of Michigan, Ann Arbor, MI, USA
  2. 2 Cardiovascular Imaging Program, Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
  1. Correspondence to Dr Ron Blankstein, 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02115, USA; rblankstein{at}

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Learning objectives

  • Understand the concept of patient-centred imaging.

  • Recognise strengths and limitations of different imaging modalities in the diagnosis of cardiovascular disease.

  • Recognise the importance of multimodality imaging training.


Imaging plays an essential role in the diagnosis and management of multiple cardiovascular diseases. The origin of non-invasive cardiovascular imaging dates back to 1953, when Inge Edler and C. Hellmuth Hertz first described the use of M-mode echocardiography to evaluate mitral stenosis and mitral regurgitation.1 Since then, the field of cardiovascular imaging has evolved to include more advanced techniques that can now detect various disease more accurately and at earlier stages. These modalities include transthoracic echocardiography, transoesophageal echocardiography, cardiac CT, cardiovascular magnetic resonance (CMR) imaging and nuclear cardiology, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. However, the availability of more testing options and more sophisticated techniques can pose a challenge to physicians who are tasked with choosing the best option for their patient, as well as integrating data from multiple tests for clinical decision making. These challenges underscore the growing need for advanced multimodality imaging specialists, as well as the need to educate general cardiologists and trainees on the strengths and limitation of various imaging tests and how to apply them to patient care. This article will provide an overview on how to educate trainees in multimodality imaging and how multimodality imaging can be effectively delivered.

Defining multimodality imaging and its applications

The premise of multimodality cardiovascular imaging is based on using a patient-centred approach to select the best available imaging test when evaluating patients with known or suspected cardiovascular disease. While many clinical questions can be answered by a single test, the effective use of multimodality cardiovascular imaging may require integrating information from various different imaging modalities to answer the clinical question at hand. A key concept in multimodality imaging is patient-centred …

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  • Contributors All authors contributed to drafting the manuscript and to content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

  • Author note References which include a * are considered to be key references.