Cardiac CT and CTFFR have a growing level of interest. The primary reason is that CT remains a noninvasive solution, which can be preferred if being used to screen patients that are suspected of coronary artery disease. It would help ensure patients with unclear or marginal risks do not need an invasive diagnostic procedure. The CT is purely diagnostic and if it provides sufficient proof there is disease, the patient must then undergo the invasive procedure to verify if there is need to therapeutically treat the condition. It may also require referring the patient to surgery depending on the specific findings. The other challenge is that the patient is typically exposed to higher radiation levels with CT than with IXR. This may still evolve into a noninvasive option to rule out coronary artery disease in younger patients, as well as those with marginal risk and without other symptomatic signs.

Hybrid Angio/CT solutions – There are a few offered by Siemens and Canon. symplr’s history of customer interest suggests these are not widely considered by mainstream healthcare providers. When they are, the customer profile tends to be University/Teaching/Research facilities. The cost is prohibitive for mainstream hospitals both in terms of capital costs and post-warranty operational costs, as well as staffing and other related operational costs.

Future vision & decision
Artificial Intelligence (AI) – The interventional procedure relies heavily on a large intake of visual and empirically measured data, as well as 3D/4D image reconstruction and output. Decisions are largely driven by the physician’s assessment of this data, thought process combined with the patient’s history and physical, and presenting conditions and symptoms. Technology like IVUS helps with data-based decisions. I believe we will see increasing interest, clinical focus and development in AI and machine learning software. This will grow not to replace the physician or their judgement, but to augment the increasingly large amount of data, information and decision-making processes facing the physicians and other healthcare personnel caring for patients in the interventional X-ray suite and procedures.

About the author: Tom Watson is principal spend advisor for symplr.

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