Contemporary nuclear cardiology practice: The Cleveland Clinic approach

Excerpt

Since the first nuclear cardiology studies were performed in the mid-1970s, clinical practice has evolved from a boutique operation performed at academic and tertiary medical centers to widespread use in community hospitals and outpatient offices. During my cardiology fellowship training, every weekday morning we met with Dr. Wackers and Zaret at 8 am sharp to read the prior day’s studies. The day before a technologist had used a tri-lens Polaroid camera attached to a funnel which was placed over a workstation screen to make hardcopy of the 3-view planar Thallium-201 images at 3 different black and white intensities. First pass studies were processed by technologists and curves generated and printed. We sat in a circle and the hard copy was passed from fellow to fellow and eventually given to Wackers or Zaret who would daven over the images and proclaim the undisputed findings that were handwritten on sheets which eventually made their way to patients chart and the requesting clinicians. When Dr. Iskandrian offered me a job in Philadelphia, he was doing mostly first pass studies and Tl-201 and reading technologist prepared hard copy print. When I started my first job in 1983 at the Seattle Veterans Administration Hospital, Drs. Ritchie, Caldwell, and I would meet for lunch every Tuesday to read a weeks’ worth of studies using a similar approach. A report eventually went out. Small volume. No computers. Technologists made decisions. No quality review. No hurry. …