UK national and regional trends in cardiovascular magnetic resonance usage – the British Society of CMR survey results

Abstract Background CMR is an imaging modality recommended for multiple indications. Access to CMR is a key issue for its clinical use. We surveyed all CMR units in the UK. Methods An online survey of CMR units in the UK, with responses analysed by region and compared with population data. Results Response rate was 100% (Table). The UK performed a total of 102,886 scans in 2017, and 117,967 in 2018 representing a 1-year 14.7% increase and a 10-year increase of 573% compared to 2008 data (20,597).By head of population in 2018 there were 1,776 CMR scans per million people, with significant variation nationally and regionally, e.g. 4,256 per million in London vs. 396 per million in Wales (Figure). Mean number of scans per unit was 1,404, (range 98–10,000) with wide variation in referral to diagnostic times (mean 45.7 days, range 5–180) (Figure). Clinical indications for CMR were: heart failure 21%, cardiomyopathy 27%, function and viability 22%, stress 24%, vascular disease 5%, valvular 5%, myocarditis/pericardial 10%, paediatric /congenital 10%, others e.g. transplant/masses 4%, with overlap. There were 358 consultants reporting CMR in 2018 (234 (65%) cardiologists and 124 (35%) radiologists). 81% of units had a CMR service for patients with pacemakers and defibrillators. Conclusion The survey shows the state of CMR in the UK. The 10-year growth has been remarkable, but there are wide disparities in terms of use, access and wait times with potential implications for clinical care. Action is needed to make access equitable across the UK. Country/Region Population (million) No. of CMR scans in 2018 No. CMR scans per million 2018 No. of CMR scans 2017 No. CMR scans per million 2017 Number of CMR Units Number of CMR scanners Number of CMR scanners per million population Number of CMR consultants Number of CMR consultant per million population Mean outpatient waiting time (days) East of England 6.3 10647 1690 8749 1389 7 9 1.4 37 5.9 39.0 London 9.2 39152 4256 33241 3613 11 27 2.9 69 7.5 28.5 England-Midlands 10.7 17525 1638 15573 1455 16 30 2.8 59 5.5 40.7 England-Northeast and Yorkshire 8.4 12285 1463 10313 1228 10 24 2.9 45 5.4 34.9 England-Northwest 7.4 12562 1698 10936 1478 9 17 2.3 37 5.0 40.4 England-Southeast 9.1 8968 985 8177 899 12 21 2.3 36 4.0 50.3 England-Southwest 6.0 8641 1440 8334 1389 8 15 2.5 28 4.7 54.9 England Total 56.0 109780 1961 95323 1703 73 143 2.6 311 5.6 40.7 Northern Ireland 1.9 2450 1302 2300 1222 1 4 2.1 10 5.3 180 Scotland 5.4 4495