#ASNC2020 Highlights – A FIT’s Perspective

 Guest Blogger: Emmanuel Akintoye, MD, FIT Member of the Social Media Task Force****The 25th Annual Scientific Session of the American Society of Nuclear Cardiology (ASNC) might have come and gone, but it will surely be remembered as a landmark event in the history of ASNC. As the first virtually held nuclear cardiology conference of its kind during a pandemic, ASNC2020 brought together the best in the field of nuclear cardiology in a new world of virtual sphere. As a fellow-in-training (FIT) and one of the social media moderators (aka SoMe photons), it was an exciting and edifying experience. It was filled with so many highlights that word count limitation will not permit me to completely express here. Hence, I can only share with you my top 5 experiences of ASNC2020.
1. Cases with the Aces
We were treated to five sessions of live reading by nuclear experts across the country, including one session from Ottawa Heart Institute in Canada which I was opportune to be the social media moderator. As a FIT, these live readings provided me with the right systematic approach to reading nuclear studies. During the Ottawa Heart Institute cases that I moderated, seven cases were discussed which included a mixture of presentations with coronary artery disease as well as cases of sarcoidosis, endocarditis, and transplant vasculopathy. Overall, the cases portrayed emerging data on transplant vasculopathy, PYP imaging, and SPECT myocardial blood flow in addition to reinforcing the continued improvement in clinical care through high quality imaging.
2. Social Media
With over 13.3 million impressions, 4,500 tweets from 425 participants across 40 countries, ASNC2020 trended as one of the top medical meetings in the world on Twitter. The hashtags #ASNC2020 and #CVNuc went viral among the Cardio Twitter community and brought the best of nuclear cardiology to the doorsteps of medical professionals across continents. In fact, it will be correct to say that more people attended ASNC2020 virtually than would have been possible if the meeting was held physically, a silver lining in midst of a pandemic. Not only did social media take the scientific component of the conference to the audience, it was also an avenue to learn about the best use of social media through two dedicated social media sessions. First, “Leveraging Social Media for Patient Care'' brought together social media experts to provide tips on how best to harness the power of Twitter to improve patient outcomes. It detailed the utility of Twitter for knowledge dissemination and instant feedback from peers and experts. A Twitter poll conducted after the session however revealed that 67% of Twitter audience who participated in the poll do not feel Twitter should be considered an academic metric yet. The second social media session, “Steering Your Tweetanic”, provided basic and advanced tips on how to create effective and engaging tweets.
3. Plenary Sessions
The plenary sessions were the core component of the meeting and included Presidents' sessions and awards, Dr. Marcelo Di Carli's Mario Verani memorial lecture on “The Evolving Role of Nuclear Cardiology in CAD Management in the Era of Multimodality Imaging," ISCHEMIA trial, and Controversies in the Contemporary era. I was opportune to moderate the ISCHEMIA trial which has generated some misconception about the utility of ischemic evaluation for coronary artery disease. Some clinicians have questioned whether there is still a role for risk stratification with nuclear myocardial perfusion imaging (MPI) in CAD since patients with moderate to high ischemic burden in the trial had similar outcome with either invasive or optimal medical therapy (OMT) approach. After listening to thoughtful speakers at the session, it was clear that MPI still has a huge role to play in the post-ISCHEMIA era. My key takeaways were that the ISCHEMIA trial strengthened our confidence in OMT; was not an imaging trial and, hence, doesn't argue against MPI; and MPI identifies high risk features beyond just ischemia. There is however no denying the fact that the ISCHEMIA trial has resulted in some changes in how cardiologists approach ischemic evaluation. In a Twitter poll I conducted shortly after the session, 16% of participants now order less MPI, 8% more MPI, 37% had no change in MPI, and 39% order more cardiac CT since the publication of the ISCHEMIA trial. Following the Plenary session were two hot debates on stent vs statin and CT vs MPI as the first line in stable ischemic heart disease. While all debaters came up with punch lines and made the right points, it was edifying to know that the patient won at the end.
4. Special Sessions
These sessions focused on Key issues that are crucial to nuclear cardiology, including application of artificial intelligence and machine learning, importance of diversity and inclusion (a joint session with the Association of Black Cardiologist), and the COVID pandemic. There was something in each for everyone. The talk on COVID was unavoidable as the pandemic has changed how we live. The role of MPI in the era of COVID was emphasized and Dr. Harvey Fineberg highlighted the significance of public policy decision making during this pandemic.
5. Intersociety Multimodality Imaging
In a joint session with SCCT, the utility of combining coronary artery calcification (CAC) scoring with MPI was emphasized and available evidence on the power of CAC were presented. My key takeaways were that CAC of zero reliably identifies low risk groups while extremely high CAC >1000 reliably identifies high risk groups that will benefit from aggressive treatment even in the absence of symptoms. As an aspiring multimodality imager, the incremental value of a combined CT/MPI study could not be clearer.
What better way to end an amazing conference than to have a seat at the table (virtually) with the leadership of ASNC and the giants in nuclear cardiology. The main program ended with a “Tweet Up and Happy Hour” session with faculty. It was a time to celebrate successes and to network with leaders in the field. It is without doubt that ASNC2020 was a huge success and will be forever remembered for so many highlights, including being the first virtual annual scientific conference of ASNC during a pandemic.  Having enjoyed my first ever ASNC annual scientific conference, I can't wait for ASNC2021.

If you missed any of the ASNC2020 sessions, don't worry. We've got you covered. The Meeting OnDemand (MOD) sessions are available through October 2021 (login to access).

Read Dr. Mrin Shetty's ASNC2020 FIT Blog

Read more blogs from the ASNC Social Media Task Force