Advanced cardiac imaging modalities in U.S. heart transplant centers: availability and distribution

Purpose: This study evaluates the availability of advanced imaging modalities, including cardiac computed tomography (CCT), cardiac magnetic resonance (CMR), cardiac positron emission tomography (PET), and intravascular ultrasound (IVUS)/optical coherence tomography (OCT), at Medicare-approved heart transplant centers across the United States. Methods: We retrieved the list of Medicare-approved heart transplant centers and data on physicians billing for cardiac imaging procedures from the CMS website. Addresses of billing physicians were matched with those of heart transplant centers to determine the availability of imaging modalities at each center. Additionally, we calculated the number of available imaging modalities and the median volume of studies per center. Further, we mapped heart transplant centers along with their available modalities. Results: Of 129 Medicare-approved heart transplant centers, 90.7% offered CCT, 85.3% provided CMR, 74.4% had IVUS/OCT, and 55% offered cardiac PET. Only 39.5% of centers had all four modalities available. Geographic disparities were observed, with clustering of centers and modalities in the Northeast and West Coast and fewer centers in the Midwest. Conclusion: This study highlights disparities in the availability of advanced imaging modalities in heart transplant centers across the United States. While CCT and CMR are widely available, the availability of cardiac PET and IVUS/OCT remains limited.