CMR in the multi-modality environment: status and perspectives

Cardiovascular magnetic resonance (CMR) as an imaging technique in cardiology is fairly recent, compared to echocardiography and nuclear imaging, but has evolved enormously over the last 20 years, with respect to technical improvements, and achieved much in terms of indications, validation, and prognostic implications. Due to several factors, including cost, expertise, availability to cardiac indications, and installed base, CMR remains underused, but things are improving, as witnessed by the growing use and increased presence of CMR in multi-modality guidelines. This can be further advanced by using the strengths of CMR and the expertise of the CMR community in the development of diagnostic pathways where CMR can find its legitimate place among the different imaging modalities. To convince the payers of this position, cost-effectiveness studies showing the efficiency and efficacy of CMR in specific indications are clearly needed. And in a world where patients themselves appropriately participate in their own diagnostic and therapeutic paths, involving patients more directly in setting up research and writing guidelines might be a key factor to the appropriate use of CMR.