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In August, Adam B. Christopher, MD, joined the Heart Institute at UPMC Children’s Hospital of Pittsburgh as its new Director of Cardiac MRI and CT. Dr. Christopher also holds an appointment as an assistant professor in the University of Pittsburgh School of Medicine Department of Pediatrics.
Dr. Christopher is fellowship-trained in both pediatric cardiology and advanced cardiac imaging. Dr. Christopher earned his medical degree from the University of Pittsburgh School of Medicine, followed by a pediatric residency at Yale-New Haven Children’s Hospital. After residency, Dr. Christopher returned to Pittsburgh to complete his pediatric cardiology fellowship at UPMC Children's Hospital. His fellowship in advanced cardiac imaging was conducted at Children’s National Hospital in Washington, DC.
“I knew from my medical school training and fellowship that the Heart Institute at UPMC Children’s offers top notch patient care, as well as support for faculty in their clinical practices and research interests. It is an honor to return to Pittsburgh and help lead the growth and expansion of the advanced cardiac imaging program,” says Dr. Christopher.
Dr. Christopher will lead the existing cardiac MRI and CT imaging program and collaborate closely with the Department of Radiology and Heart Institute colleagues to expand capabilities of the imaging program in an effort to increase access for patients and provide clinicians with the diagnostic imaging data they require to optimize patient care.
“Cardiac MRI and CT have become increasingly important to the disciplines of cardiology and cardiothoracic surgery. Echocardiography will always be our first line imaging modality, but there are a growing number of indications for advanced imaging, and the better we are at harnessing the power of these newer technologies and interpreting the findings we obtain, the better our patient outcomes will be. That is the singular goal we all are pursuing: better patient care," says Dr. Christopher.
The program also will be expanding the number of days that cardiac MR and CT scans are conducted to improve accessibility and create shorter wait times for patients, particularly those cases that require sedation or general anesthesia.
In conjunction with enhancements to the existing cardiac catheterization laboratories led by Bryan Goldstein, MD, the Heart Institute at UPMC Children's is in the planning phases to build a new interventional cardiac MR (ICMR) suite that has a conventional interventional catheterization table with fluoroscopy capabilities at one end of the room, and an MRI magnet on the other side.
This hybrid room will allow simultaneous catheterization procedures and MR procedures for separate patients. Also, catheterization patients and procedures that need cardiac MR before or during the procedure for guidance can simply be transferred to the other end of the room under the same anesthetic.
“The new suite will open up a host of research, clinical care, and quality improvement opportunities for our faculty and patients. We will have the ability to gain MR acquired data on patients during catheterization procedures for research, while at the same time reducing the radiation exposure to patients in certain clinical scenarios,” says Dr. Christopher.
The hybrid suite will facilitate fewer sedated or anesthetized procedures for some patients because of the combined abilities and proximity of the interventional space with the MR imaging.
The new MR scanner also brings with it motion detection capabilities that can cancel out a patient's motion during imaging procedures, providing better image quality and data acquisition. Patient motion during imaging procedures is of general concern but magnified when performing imaging on children who have less capability to follow instructions for long periods of time, such as with breath holds during scans.
"Many of our patients are not MR candidates because of pacemakers or other metal objects in the body, so for them, CT will always be necessary. CT does provide higher resolution imaging than cardiac MR, and it will always have a role in our practice. The new CT technology that we will be integrating has better quality, faster image acquisition, and lower radiation exposure levels, which will provide many benefits for our patients. Each patient is unique and the risks and benefits of each imaging modality must be matched with nuanced clinical questions. That is where my expertise comes in to play – assisting our physicians, surgeons, and radiology partners in obtaining the critical diagnostic findings they need and interpreting those findings to better guide clinical decision making,” says Dr. Christopher.
Dr. Christopher’s imaging research interests lie in the use of anesthesia reduction technologies and motion detection in cardiac imaging procedures. His past work also has involved studying the noninvasive assessment of myocardial disease, including heart transplant rejection through MR imaging. At present, standards of care involve using invasive biopsies to sample myocardial tissues, but proving the efficacy of noninvasive imaging to assess myocardial disease with the same accuracy as tissue biopsy will require much more proof before it can become a trusted method of diagnosis and detection.
"I am also excited to support the many ongoing areas of research within our Heart Institute with cardiac imaging data. The radiation-free assessment of heart muscle size, function, and character offered by cardiac MRI is applicable to countless research questions both within and beyond the Division of Cardiology. I cannot wait to see all that we can learn by expanding this program and leveraging these tools to support the Heart Institute," says Dr. Christopher.