To discuss the transition in pediatric cardiovascular imaging from anatomic depiction to quantitative, multimodal, and decision-oriented care, emphasizing the need to minimize radiation and sedation.
Approach:
Introduction: Pediatric cardiovascular imaging is evolving to minimize radiation and sedation while improving assessment of congenital and acquired heart conditions. This transition is illustrated by 12 articles that highlight advancements in various imaging modalities.
Ultrasound-based diagnosis and quantitative echocardiography: Studies demonstrate the importance of ultrasound and its expanding diagnostic capabilities, including prenatal diagnosis and detection of cardiotoxicity, as well as the role of deformation and multi-parameter echocardiography.
Cross-sectional, computational, and flow imaging: Advanced imaging techniques are being developed for patient-specific quantification, enhancing surgical planning and understanding of vascular remodeling through quantitative metrics.
Electrophysiologic imaging, mapping, and multimodality care: The integration of imaging with biomarkers and clinical trajectories is emphasized, showcasing the value of multimodality approaches in pediatric care.
Future directions: Future work should focus on reproducibility, age-specific reference values, and the integration of artificial intelligence to improve workflow and measurement consistency.
Key Findings:
Pediatric cardiovascular imaging is becoming more quantitative and personalized, with advancements in various imaging modalities.
Emerging technologies improve diagnostic confidence and guide individualized treatment.
Integration of various imaging modalities enhances understanding of complex pediatric conditions.
Interpretation:
The field is shifting towards imaging as a decision support tool, aligning innovations with the needs of pediatric patients.
Limitations:
Pediatric datasets are often small and heterogeneous, complicating validation of new imaging technologies.
Implementation of new technologies must consider accessibility and cost.
Conclusion:
Emerging pediatric cardiovascular imaging technologies can support earlier diagnosis by aligning technical innovation with clinical needs.
Heart rate monitoring and atrial fibrillation detection had the strongest supporting evidence, but investigators found limited evidence for broader outpatient self-monitoring applications.
