3D Echo Coming of Age to Monitor Heart Function in Cancer Patients


3D Echo Technology

Photo Courtesy of TomTec Imaging Systems

In today’s medical environment, oncologists have a seemingly endless supply of new drugs and treatment modalities that work toward curing patients of cancer. Aggressive cancers require aggressive treatments, but at the same time, care must be taken to protect the overall health of patients.

The result is a delicate balance among the often-harsh radiation and/or chemotherapy drugs necessary to shrink tumors, the potential for debilitating side effects and the real risk of permanent damage to unaffected parts of the body, such as the heart. Many of the drugs used in chemotherapy are toxic to the cardiac muscle and can lead to irreversible heart damage.

Use of 3D echocardiograms allows cardiologists to set baseline measurements for patients about to undergo aggressive therapies for cancer. As the chemo proceeds, additional noninvasive scans can be ordered to compare current cardiac structure and function with the baseline. If the cancer is not responding to the current treatment but the heart is OK, a stronger dose or a different drug can be used. But if damage is noted, treatment can be suspended or changed before additional damage occurs.

McKesson Cardiology™ Echo and Vascular Ultrasound, an echocardiography solution, incorporates comprehensive 3D/4D advanced analysis and visualization solutions from TomTec Imaging Systems, long recognized as a leader in 3D echo. The increasing need to monitor subclinical deteriorations and LV/RV remodeling underscores the utility of 3D imaging to help improve patient care, says Peter Roesch, vice president of sales and marketing for TomTec.

“The integration of 3D echo into the routine workflow will enable more hospitals to use 3D imaging to improve patient care,” Roesch says. “For cancer patients, it increases diagnostic quality and helps oncologists and cardiologists manage patients appropriately.”

In order to manage patients over time, measurements must be highly reproducible. Solutions based on automated contour detection and tracking algorithms help to significantly reduce inter- and intra-observer variability, which is essential to assess therapy outcome, Roesch notes.

TomTec solutions are highly automated and support clinicians’ ability to track changes in global longitudinal strain or end-diastolic volumes. They are vendor-neutral and seamlessly integrated into McKesson Cardiology. “Improving patient care is what it’s all about,” Roesch says.

For larger hospitals that perform dozens of echocardiograms each day, tools that aren’t integrated into the clinician’s routine workflow might not be utilized to the full extent. Even a couple of extra steps multiplied over a day’s worth of scans impacts the efficiency of the echo lab. “Physicians can read studies in McKesson Cardiology, and access advanced analysis tools with just one mouse click,” Roesch says.

“Automated analysis tools allow clinicians to measure subclinical markers, such as global longitudinal strain, to detect LV dysfunction before changes in the heart can be seen,” says the TomTec executive, noting the importance of 3D echo to measure heart function.

The use of 3D imaging has become more widespread recently, in part because more payers are reimbursing for its use. But as the seismic shift from fee-for-service continues, greater emphasis is being placed on the quality of care received and outcomes.

We believe that 3D imaging will play an important role not only in monitoring the cardiac function of patients with aggressive cancers but in the future of medical imaging.

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