EACVI Survey on the Use and Delivery of Multimodality Cardiac Imaging

The present survey, led by the EACVI Scientific Initiatives Committee, aims is to investigate the utilisation of multimodality imaging in Europe and worldwide, explore the organizational and reimbursement frameworks for cardiac imaging services across different nations, assess cardiologists' involvement in different imaging modalities, and identify practical barriers hindering the broader implementation of multimodality approach in cardiovascular imaging.
Your input in this survey will help us grasp the current state of cardiovascular multimodality imaging, enabling us to improve strategies in cardiac care. Thank you for contributing to this vital endeavor!

May we remind you of the codes of conduct related to market research among healthcare professionals:
· The survey is anonymous
· You have the right to end your participation in this survey at any time
· We comply with the European General Data Protection Regulation (GDPR) 2016/679. Any personal data processed in connection with this survey will be treated confidentially and only used for the purposes of market research. Material and data collected from you will be analysed overall, used internally by the ESC and kept for a maximum of 24 months for analysis and quality control purposes. We take all reasonable care to prevent any unauthorised access to your personal data. We respect your privacy and your right to access, modify, or suppress your personal data. At any time, you can ask to know what personal data is being held. If you have any questions about data protection or require further information, please contact our data protection officer DPO@escardio.org

Question Title

* 1. May we please ask you to confirm you have read the clauses above and accept participation in this survey?

Yes

Question Title

* 2. In which country do you practice ? (free text)

Question Title

* 3. What is the type of practice/hospital you work in? (single choice)

Primary care

Secondary care/district hospital

Tertiary care/university hospital

Private hospital

Question Title

* 4. What is your age range? (single choice)

Under 30 years old

30–39 years old

40–49 years old

50–60 years old

Over 60 years old

Question Title

* 5. What is your profession (applicable also if you are in training)?

Cardiology

Radiology

Nuclear medicine

Dual accredited (cardiology and radiology)

Dual accredited (cardiology and nuclear medicine)

Dual accredited (radiology and nuclear medicine)

Other (please specify)

Question Title

* 6. What is your imaging expertise? (multiple choice)

Echocardiography

Cardiac magnetic resonance (CMR)

Cardiac computed tomography (CCT)

Single-photon emission computed tomography (SPECT)

Positron emission tomography (PET)

Other (please specify)

Question Title

* 7. For which imaging modalities are you certified? (multiple choice)

EACVI certification in adult transthoracic echocardiography

EACVI certification in adult transoesophageal echocardiography

ASE certification in adult transthoracic echocardiography

ASE certification in adult transoesophageal echocardiography

EACVI certification in CMR - Level 2

EACVI certification in CMR - Level 3

SCMR certification in CMR - Level 2

SCMR certification in CMR - Level 3

EACVI certification in CCT - Level 2

EACVI certification in CCT - Level 3

SCCT certification in CCT - Level 2

SCCT certification in CCT - Level 3

EACVI/EANM certification in nuclear cardiology

ASCN certification in in nuclear cardiology

European Board of Cardiovascular Radiology (EBCR) Diploma

EACVI certification in multi-modality Imaging (MMI)

Other (please specify)

Question Title

* 8. Which cardiac imaging modalities are available in your centre? (multiple choice)

Echocardiography

CMR

CCT

SPECT

PET

Question Title

* 9. Is there a multimodality cardiac imaging department/unit in your institution? If yes, which imaging facilities are co-located in this unit? (multiple choice)

Echocardiography

CMR

CCT

SPECT and/or PET

Other (please specify)

No multimodality cardiac imaging unit in my centre

Question Title

* 10. Is there a multimodality cardiac imaging department/unit in your institution? if yes, which imaging specialists are working in this unit?

Cardiologists

Radiologists

Nuclear imaging specialists

Other (please specify)

No multimodality cardiac imaging unit in my centre

Question Title

* 11. In which department is each modality performed? Please select all applicable answers, for instance if some exams are performed at cardiology, some at radiology, some at nuclear imaging department, select all these anwers (multiple choice)

	Cardiology	Radiology	Nuclear imaging department	Co-managed imaging unit	Not applicable
Echocardiography	Echocardiography Cardiology	Echocardiography Radiology	Echocardiography Nuclear imaging department	Echocardiography Co-managed imaging unit	Echocardiography Not applicable
CMR	CMR Cardiology	CMR Radiology	CMR Nuclear imaging department	CMR Co-managed imaging unit	CMR Not applicable
CCT	CCT Cardiology	CCT Radiology	CCT Nuclear imaging department	CCT Co-managed imaging unit	CCT Not applicable
Nuclear Cardiology	Nuclear Cardiology Cardiology	Nuclear Cardiology Radiology	Nuclear Cardiology Nuclear imaging department	Nuclear Cardiology Co-managed imaging unit	Nuclear Cardiology Not applicable

Question Title

* 12. Are there any legal issues in your country preventing cardiologist to practice cardiac imaging? You can provide more detailed explanation in the comment section (single choice)

	Yes	No	Unclear situation	I don't know	Not applicable
Echocardiography	Echocardiography Yes	Echocardiography No	Echocardiography Unclear situation	Echocardiography I don't know	Echocardiography Not applicable
CMR	CMR Yes	CMR No	CMR Unclear situation	CMR I don't know	CMR Not applicable
CCT	CCT Yes	CCT No	CCT Unclear situation	CCT I don't know	CCT Not applicable
Nuclear Cardiology	Nuclear Cardiology Yes	Nuclear Cardiology No	Nuclear Cardiology Unclear situation	Nuclear Cardiology I don't know	Nuclear Cardiology Not applicable

Any comment

Question Title

* 13. For which imaging modalities can cardiology get reimbursed in your country (according to the legal / health insurance regulations)? (multiple choice)

Echocardiography

CMR

CCT

SPECT

PET

I don’t know

Question Title

* 14. Who reports the exams in your centre? Please select all applicable answers for each modality. (multiple choice)

	Echocardiography	CMR	Stress CMR	CCT	Nuclear Cardiology
Cardiologists	Cardiologists Echocardiography	Cardiologists CMR	Cardiologists Stress CMR	Cardiologists CCT	Cardiologists Nuclear Cardiology
Radiologists	Radiologists Echocardiography	Radiologists CMR	Radiologists Stress CMR	Radiologists CCT	Radiologists Nuclear Cardiology
Nuclear imaging specialists	Nuclear imaging specialists Echocardiography	Nuclear imaging specialists CMR	Nuclear imaging specialists Stress CMR	Nuclear imaging specialists CCT	Nuclear imaging specialists Nuclear Cardiology
Cardiologists and radiologists co-report	Cardiologists and radiologists co-report Echocardiography	Cardiologists and radiologists co-report CMR	Cardiologists and radiologists co-report Stress CMR	Cardiologists and radiologists co-report CCT	Cardiologists and radiologists co-report Nuclear Cardiology
Cardiologists and nuclear imaging specialists co-report	Cardiologists and nuclear imaging specialists co-report Echocardiography	Cardiologists and nuclear imaging specialists co-report CMR	Cardiologists and nuclear imaging specialists co-report Stress CMR	Cardiologists and nuclear imaging specialists co-report CCT	Cardiologists and nuclear imaging specialists co-report Nuclear Cardiology
Radiologists and nuclear imaging specialists co-report	Radiologists and nuclear imaging specialists co-report Echocardiography	Radiologists and nuclear imaging specialists co-report CMR	Radiologists and nuclear imaging specialists co-report Stress CMR	Radiologists and nuclear imaging specialists co-report CCT	Radiologists and nuclear imaging specialists co-report Nuclear Cardiology
Cardiologists write a separate report/clinical notes on top of the official report by other specialists	Cardiologists write a separate report/clinical notes on top of the official report by other specialists Echocardiography	Cardiologists write a separate report/clinical notes on top of the official report by other specialists CMR	Cardiologists write a separate report/clinical notes on top of the official report by other specialists Stress CMR	Cardiologists write a separate report/clinical notes on top of the official report by other specialists CCT	Cardiologists write a separate report/clinical notes on top of the official report by other specialists Nuclear Cardiology
Not applicable	Not applicable Echocardiography	Not applicable CMR	Not applicable Stress CMR	Not applicable CCT	Not applicable Nuclear Cardiology

If more than one answer applies, please provide an estimate of the percentage of exams performed by each group per modality (e.g. CMR: cardiologist 40%, radiologist 60%)

Question Title

* 15. How would you assess clinical relevance of cardiac imaging reports at your center? (single choice)

	Highly clinically relevant	Clinically relevant	Not really clinically relevant	Not at all clinically relevant	I cannot judge the clinical relevance of the reports	Not applicable
Echocardiography	Echocardiography Highly clinically relevant	Echocardiography Clinically relevant	Echocardiography Not really clinically relevant	Echocardiography Not at all clinically relevant	Echocardiography I cannot judge the clinical relevance of the reports	Echocardiography Not applicable
CMR	CMR Highly clinically relevant	CMR Clinically relevant	CMR Not really clinically relevant	CMR Not at all clinically relevant	CMR I cannot judge the clinical relevance of the reports	CMR Not applicable
CCT	CCT Highly clinically relevant	CCT Clinically relevant	CCT Not really clinically relevant	CCT Not at all clinically relevant	CCT I cannot judge the clinical relevance of the reports	CCT Not applicable
Nuclear Cardiology	Nuclear Cardiology Highly clinically relevant	Nuclear Cardiology Clinically relevant	Nuclear Cardiology Not really clinically relevant	Nuclear Cardiology Not at all clinically relevant	Nuclear Cardiology I cannot judge the clinical relevance of the reports	Nuclear Cardiology Not applicable

Question Title

* 16. What is the minimum requirement for cardiologists to perform echocardiography at your centre? (single choice)

Valid cardiology license (no additional requirements)

Specific training programme/certification in echocardiography as defined at a national level

EACVI certification of competency in echocardiography

ASE certification of competency in echocardiography

I don’t know

Other (please specify)

Cardiologist do not perform echocardiography in my center

Question Title

* 17. What is the minimum requirement for cardiologists to perform CMR at your centre? (single choice)

Valid cardiology license (no additional requirements)

Dual accreditation (cardiology and radiology)

Specific training program/certification in CMR as defined at a national level

EACVI certification in CMR – Level 2

EACVI certification in CMR – Level 3

SCMR certification in CMR – Level 2

SCMR certification in CMR – Level 3

European Board of Cardiovascular Radiology (EBCR) Diploma

I don’t know

Other (please specify)

Cardiologist do not perform CMR at my center

Question Title

* 18. What is the minimum requirement for cardiologists to perform CCT at your centre? (single choice)

Valid cardiology license (no additional requirements)

Dual accreditation (cardiology and radiology)

Specific training program/certification in CCT as defined at a national level

EACVI certification in CCT - Level 2

EACVI certification in CCT - Level 3

SCCT certification in CCT - Level 2

SCCT certification in CCT - Level 3

European Board of Cardiovascular Radiology (EBCR) Diploma

I don’t know

Other (please specify)

Cardiologist do not perform CCT at my center

Question Title

* 19. What is the minimum requirement for cardiologists to perform nuclear cardiology (SPECT, PET) at your centre? (single choice)

Valid cardiology license (no additional requirements)

Dual accreditation (cardiology and nuclear medicine)

Specific training program/certification in nuclear cardiology as defined at a national level

EACVI/EANM certification in nuclear cardiology

ASCN certification in nuclear cardiology

I don’t know

Other (please specify)

Cardiologist do not perform nuclear cardiology at my center

Question Title

* 20. According to your opinion, are cardiologists satisfactorily involved in different imaging modalities at your centre? Please select all applicable for each modality. (multiple choice)

	Echocardiography	CMR	CCT	Nuclear Cardiology
Yes	Yes Echocardiography	Yes CMR	Yes CCT	Yes Nuclear Cardiology
Nu, due to a lack of interest in the modality	Nu, due to a lack of interest in the modality Echocardiography	Nu, due to a lack of interest in the modality CMR	Nu, due to a lack of interest in the modality CCT	Nu, due to a lack of interest in the modality Nuclear Cardiology
No, due to a lack of appropriate training	No, due to a lack of appropriate training Echocardiography	No, due to a lack of appropriate training CMR	No, due to a lack of appropriate training CCT	No, due to a lack of appropriate training Nuclear Cardiology
No, due to a lack of facilities (scanners,..)	No, due to a lack of facilities (scanners,..) Echocardiography	No, due to a lack of facilities (scanners,..) CMR	No, due to a lack of facilities (scanners,..) CCT	No, due to a lack of facilities (scanners,..) Nuclear Cardiology
No, due to legal constraints (not allowed to perform the modality)	No, due to legal constraints (not allowed to perform the modality) Echocardiography	No, due to legal constraints (not allowed to perform the modality) CMR	No, due to legal constraints (not allowed to perform the modality) CCT	No, due to legal constraints (not allowed to perform the modality) Nuclear Cardiology
No, due to the excellent services provided by other specialists (no need to be involved)	No, due to the excellent services provided by other specialists (no need to be involved) Echocardiography	No, due to the excellent services provided by other specialists (no need to be involved) CMR	No, due to the excellent services provided by other specialists (no need to be involved) CCT	No, due to the excellent services provided by other specialists (no need to be involved) Nuclear Cardiology
No, due to professional barriers preventing effective collaboration with other specialists performing the modality	No, due to professional barriers preventing effective collaboration with other specialists performing the modality Echocardiography	No, due to professional barriers preventing effective collaboration with other specialists performing the modality CMR	No, due to professional barriers preventing effective collaboration with other specialists performing the modality CCT	No, due to professional barriers preventing effective collaboration with other specialists performing the modality Nuclear Cardiology
Cardiologist should not be involved in the modality (it is a domain for other specialists)	Cardiologist should not be involved in the modality (it is a domain for other specialists) Echocardiography	Cardiologist should not be involved in the modality (it is a domain for other specialists) CMR	Cardiologist should not be involved in the modality (it is a domain for other specialists) CCT	Cardiologist should not be involved in the modality (it is a domain for other specialists) Nuclear Cardiology
Not applicable (no this modality in my institution)	Not applicable (no this modality in my institution) Echocardiography	Not applicable (no this modality in my institution) CMR	Not applicable (no this modality in my institution) CCT	Not applicable (no this modality in my institution) Nuclear Cardiology

Cardiologists are not satisfactorily involved for other reasons. Please specify which for each modality:

Question Title

* 21. What is the mode of cooperation between cardiologists and other imaging specialists (radiologists, nuclear imaging specialists) for each modality at your centre? You can provide alternative answers or more detailed explanation of your answer in the comment box. (multiple choice)

	Echocardiography	CMR	CCT	Nulcear Cardiology
Co-reporting on all exams	Co-reporting on all exams Echocardiography	Co-reporting on all exams CMR	Co-reporting on all exams CCT	Co-reporting on all exams Nulcear Cardiology
Co-reporting on some exams	Co-reporting on some exams Echocardiography	Co-reporting on some exams CMR	Co-reporting on some exams CCT	Co-reporting on some exams Nulcear Cardiology
Regular multidisciplinary team meetings	Regular multidisciplinary team meetings Echocardiography	Regular multidisciplinary team meetings CMR	Regular multidisciplinary team meetings CCT	Regular multidisciplinary team meetings Nulcear Cardiology
Cooperation in research projects	Cooperation in research projects Echocardiography	Cooperation in research projects CMR	Cooperation in research projects CCT	Cooperation in research projects Nulcear Cardiology
No structured cooperation (cases discussed based on individual initiatives)	No structured cooperation (cases discussed based on individual initiatives) Echocardiography	No structured cooperation (cases discussed based on individual initiatives) CMR	No structured cooperation (cases discussed based on individual initiatives) CCT	No structured cooperation (cases discussed based on individual initiatives) Nulcear Cardiology
No communication	No communication Echocardiography	No communication CMR	No communication CCT	No communication Nulcear Cardiology
Not applicable	Not applicable Echocardiography	Not applicable CMR	Not applicable CCT	Not applicable Nulcear Cardiology

Any additional comment (please specify for which modality)

Question Title

* 22. How would you describe the cooperation between different specialists performing cardiac imaging at your centre? (single choice)

	Excellent	Good	Average	Poor	Very poor	Not applicable
Cardiologists and radiologists	Cardiologists and radiologists Excellent	Cardiologists and radiologists Good	Cardiologists and radiologists Average	Cardiologists and radiologists Poor	Cardiologists and radiologists Very poor	Cardiologists and radiologists Not applicable
Cardiologists and nuclear imaging specialists	Cardiologists and nuclear imaging specialists Excellent	Cardiologists and nuclear imaging specialists Good	Cardiologists and nuclear imaging specialists Average	Cardiologists and nuclear imaging specialists Poor	Cardiologists and nuclear imaging specialists Very poor	Cardiologists and nuclear imaging specialists Not applicable
Radiologists and nuclear imaging specialists	Radiologists and nuclear imaging specialists Excellent	Radiologists and nuclear imaging specialists Good	Radiologists and nuclear imaging specialists Average	Radiologists and nuclear imaging specialists Poor	Radiologists and nuclear imaging specialists Very poor	Radiologists and nuclear imaging specialists Not applicable