A framework for increasing scanner efficiency: the utility of a ‘Short aorta’ protocol to increase cardiac MRI capacity at the Yorkshire Heart Centre

There are rising demands for cardiovascular magnetic resonance imaging (CMR) worldwide. Thoracic aorta assessment is a common CMR indication. There are many benefits to shorter scan times including improved patient experience, as well as efficiency of a service.

This service development project aimed to optimize the current ‘aorta’ protocol in a large tertiary CMR centre in the United Kingdom (which includes aortic valve [AV] and left ventricle [LV] assessment), with the aim to reduce scanning and reporting times. A ‘Short aorta’ protocol was devised (where only the thoracic aorta is assessed). The ‘Short aorta’ protocol requires a 30-minute scan slot, whereas the ‘Full aorta’ protocol (assessing thoracic aorta, AV and LV function) requires 60 minutes.

This project retrospectively analysed clinical and scan characteristics of patients referred to the Yorkshire Heart Centre for CMR before and after introduction of a ‘Short aorta’ protocol.

Over the two 13-week audit periods, thoracic aorta assessment was the main indication for 137 CMR referrals. Based on clinical indication, 95 (69%) could have used the ‘Short aorta’ protocol. After introduction of the ‘Short aorta’ protocol, 39 (46%) of 85 scans were protocolled as ‘Short aorta’. This resulted in significantly reduced scan times compared to the original ‘aorta’ protocol: 18 (IQR 15, 21) vs. 37 (IQR 32, 42) minutes; P = <0.0001).

Over the second audit period, 1.2 h of scanner time per week was saved. With appropriate protocolling and booking, 1.9 h of scanner time could be saved. This is significant capacity which can improve waiting times, offering better service for patients.