2025 Stress MR III In DC: A Hands-On Workshop-Day 1 - Part II: Nuts and Bolts of Starting a Stress CMR Program

Video Transcription

Video Summary

The session focused on how to launch and grow a stress cardiac MRI program. It began with a “business case” talk emphasizing that programs need strong margins or revenue to support their mission. The speaker reviewed relative value units, Medicare and hospital outpatient payments, payer mix, and additional revenue opportunities such as vascular, device, stress, and parametric mapping codes. Key advice included billing correctly, using T-codes when appropriate, protecting imaging time, and making the case to hospital leadership with realistic revenue projections.<br /><br />A second talk reviewed pharmacologic stress agents for CMR. Vasodilators are first-line, with adenosine and regadenoson the most common. The speaker compared mechanisms, dosing, contraindications, side effects, and workflow considerations. Dobutamine was discussed as an alternative when vasodilators are not suitable. The main message was that agent choice depends on patient factors, safety, logistics, and institutional preference.<br /><br />A detailed video then demonstrated a full stress MRI exam from patient preparation through imaging and recovery. It highlighted informed consent, device screening, monitoring, IV setup, timing of contrast and stress drug infusion, and managing side effects.<br /><br />The panel discussion covered practical workflow issues: collaboration between cardiology and radiology, patient pre-scan communication, staffing models, consent requirements, IV and contrast protocols, training technologists, and the value of a nurse navigator. Speakers stressed starting small, building quality assurance, and maintaining strong teamwork.<br /><br />The session ended with a case-based discussion of complex MRI interpretation, showing how stress CMR can clarify diagnoses such as Fabry disease, infarction, and ischemia.

Keywords

stress cardiac MRI

CMR program

business case

relative value units

Medicare reimbursement

hospital outpatient payments

pharmacologic stress agents

adenosine

regadenoson

dobutamine

workflow optimization

quality assurance

Fabry disease