Barriers to cardiovascular magnetic resonance imaging scan performance and reporting by cardiologists: a systematic literature review.

Abstract

Aims: Cardiovascular magnetic resonance (CMR) imaging plays a pivotal role in diagnosing and managing cardiovascular diseases. Its use has shown sustained growth over the past years. However, there is considerable variability in the use and reporting of CMR scans worldwide. This review provides synthesis of evidence on the barriers and challenges to performing CMR scans by cardiologists and gain insights into the variations in CMR scan practices across different countries.

Methods and results: We systematically reviewed the literature from 1 January 2003 up to 13 November 2023. We searched four databases (Ovid Medline, Embase, Web of Science, and Scopus) and hand-searched the references in the included articles, complemented by expert feedback. Articles were double screened against pre-defined inclusion and exclusion criteria. We conducted risk of bias using the JBI critical appraisal tool, and we analysed information using a narrative synthesis of results. We identified 14 857 articles, with 13 articles meeting the inclusion criteria. The key barriers were the limited availability of CMR scanners, resulting in extended waiting times, the high service cost, and limited training opportunities and the lack of a structured curriculum. The main practice variations identified were geographical disparities in CMR use. Worldwide, the majority of CMR training programmes are situated in radiology departments.

Conclusion: Barriers to CMR use by cardiologists range from access to scanners and prohibitive costs to disparities in familiarity with CMR technology. Geographic variations and heterogeneity in training programmes underscore the influence of systemic factors such as healthcare infrastructure, reimbursement policies, and unstandardized training curricula.