Cross-sectional imaging is recognised as a subspeciality that provides a comprehensive cardiac imaging service with ‘themed for service’ capabilities in practice (CiPS) on both the paediatric and adult cardiology curriculum that need to be met by a trainee to demonstrate competence. UK trainees with a national training number (NTN) in paediatric and adult cardiology are able to pursue CSI cardiology as a subspeciality in their final two years of training (ST7 and 8).

For each imaging modality the doctor performing or supervising the scan will be expected to attain appropriate accreditation within that field and maintain a log book. Trainees are also expected to attend conferences and courses in their chosen imaging modalities.

In order to achieve sufficient log book cases some trainees may need to arrange an out-of-programme fellowship.

1. Echocardiography

Transthoracic echocardiography forms the cornerstone of congenital heart disease diagnosis and management. All trainees are expected to obtain EACVI accreditation in congenital heart disease transthoracic echocardiography. Sub-specialisation in advanced echocardiography techniques will require training in peri-operative transoesophageal echocardiography as well as developing expertise in techniques such as 3D echocardiography, stress echocardiography and speckle tracking myocardial deformation. As the field advances they will be expected to train in novel techniques and remain informed of the emerging evidence base/guidelines, further information on this subspecialty is available here and there is significant information on the subject in the congenital physiology section.

Accreditation

• EACVI congenital heart disease echocardiography

• EACVI transoesophageal echocardiography

2. Computed Tomography (CT)

• Congenital CT Scans: ECG-gated CT can help visualise cardiac structures and assess conditions like cardiac masses, congenital heart disease, and other anatomical abnormalities. The field of CHD CT imaging is evolving and does not yet have specific accreditation available but is included as part of the EACVI CCT accreditation.

• Cardiac CT Angiography: For those working in adult congenital heart disease coronary imaging is paramount and forms a Speciality CiP for all trainees.  For those specialising in CSI appropriate accreditation and experience of reporting coronary CT is expected.

Accreditation

• EACVI Cardiac Computed Tomography

3. Magnetic Resonance Imaging (MRI)

Cardiac MRI is integral in both acquired and congenital heart disease. Although accreditation is available for purely congenital heart disease it is expected that trainees specialising in MRI will also obtain experience in supervising and reporting inherited cardiac conditions and stress CMR.

Accreditation

• EACVI congenital CMR level 2/3

• EACVI CMR level 2/3

• SCMR level 2/3

4. Positron Emission Tomography (PET)

This is a functional imaging technique that uses intravenous radioactive tracers to visualise and measure changes in metabolic processes, including blood flow. Used mainly for assessing myocardial perfusion and viability, PET imaging provides functional information alongside anatomical data. It can be particularly useful in complex cases where other imaging may be inconclusive.

Accreditation

• EACVI/EANM Certification in Nuclear Cardiology