View From the Field

How to Enhance Your Cardiac PET Program – Insights from Two Rush Cardiologists

The cardiac PET program at Rush University Medical Center was in its first year when ASNC2019 came to Chicago. Rush has the only cardiac PET program in the greater Chicago area and it was doing quite well – so much so that Director of Nuclear Cardiology Rupa M. Sanghani, MD, FASNC, invited ASNC2019 attendees to tour the Rush facility last September.
Still, the Rush team wanted to continue improving.
“As a new program, I quickly realized that my readers needed more training, in particular on artifact recognition and flow reserve,” said Dr. Sanghani. “It’s critical for all PET programs to have all of readers trained appropriately. For us, that meant sending all eight of our nuclear cardiology readers to ASNC’s Cardiac PET Intensive Workshops.” 
The team also wanted to standardize their reporting so referring providers were consistently receiving reports that “included all of the elements of clinical, PET and CT data,” said Rami Doukky, MD, MSc, FASNC, cardiology chair at nearby Cook County Health and a member of the Rush team. “Such coherent reporting can help referring physicians take better care of their patients.”     
Personalized, case-based training near Washington, D.C. 
With those goals in mind, six of the Rush nuclear cardiologists traveled to the Washington, D.C., metro area for a weekend in November of last year. Alongside expert faculty led by Marcelo Di Carli, MD, MASNC, they read 60+ cases and quickly expanded their ability to perceive subtle nuances that affect interpretation, recognize artifacts, and better understand how to quantify myocardial blood flow and flow reserve.
“You read the guidelines, but it’s all about seeing real cases in their clinical context,” Dr. Sanghani said.  “That’s where you learn how to approach flow quantification and how to interpret that information in a way that makes sense for your referring physicians.” 
ASNC’s personalized approach is key to the high marks that attendees consistently give the PET workshops, said Dr. Doukky. Shortly after attendees register, ASNC program planners contact them, asking a few questions that assess their experience with cardiac PET and their goals. Using that information, ASNC groups the workshop attendees so they will work through the cases with colleagues of similar skills who are using the same radiotracer. 
The result is an educational experience that feels customized to every physician at the workshop, Drs. Sanghani and Doukky said. 
Back home  Big impact on practice 
“I consider myself an expert nuclear cardiologist with vast experience with SPECT imaging and a good understanding of PET technology and practice,” Dr. Doukky explained. “Despite my background, the PET workshop was tremendously helpful, and I was able to apply the knowledge I acquired at the ASNC workshop immediately.”
Asked to tally up the impact of attending the workshop, Drs. Sanghani and Doukky noted these results: 
  • Improved interpretation, artifact recognition, and understanding of quantifying myocardial blood flow and flow reserve;
  • An effective strategy for navigating through complex cases, such as those where the perfusion, coronary flow, calcium and/or other ancillary data conflict;
  • Enhanced understanding of inflammation imaging; and
  • Standardized reporting that supports their referring physicians’ efforts to optimize patient care and outcomes.
 Plus, ongoing updates on reimbursement 
The workshop that Drs. Doukky and Sanghani attended was in session when the Centers for Medicare & Medicaid Services (CMS) released the 2020 physician fee schedule. ASNC CEO Kathy Flood shared breaking news: CMS had been persuaded by the Society’s advocacy efforts and reversed its proposed 80 percent reimbursement cuts for PET imaging. Being on the front lines of such news made the workshop especially memorable for the November attendees.
In fact, reimbursement updates are always on the agenda at ASNC’s workshops. At ASNC’s March 7-8, 2020, workshop, attendees will learn about the new PET/CT codes; how to bill for absolute quantitation of myocardial blood flow; and the ins and outs of billing for hospital vs. physician office PET imaging.
In keeping with their goal of getting all of their readers trained, Rush Cardiology is sending the other two members of its eight-person team – Kim Williams, MD, MASNC, and Alan Goldberg, MD, FASNC – to attend ASNC’s March 7-8 workshop in the Washington, D.C., area.
“Look at Dr. Williams – an expert nuclear cardiologist with decades of experience and a Master of ASNC!” said Dr. Sanghani. “He was 100 percent on board when I suggested all of us attend the ASNC workshops. It’s that important, and the ASNC program is that good.”
Committed to maintaining the PET workshop’s personalized, interactive format, ASNC limits attendance to 75 physicians. To claim your spot, register now.