What is multimodality cardiovascular imaging and how can it be delivered?

### Learning objectives Imaging plays an essential role in the diagnosis and management of multiple cardiovascular diseases. The origin of non-invasive cardiovascular imaging dates back to 1953, when Inge Edler and C. Hellmuth Hertz first described the use of M-mode echocardiography to evaluate mitral stenosis and mitral regurgitation.1 Since then, the field of cardiovascular imaging has evolved to include more advanced techniques that can now detect various disease more accurately and at earlier stages. These modalities include transthoracic echocardiography, transoesophageal echocardiography, cardiac CT, cardiovascular magnetic resonance (CMR) imaging and nuclear cardiology, including single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. However, the availability of more testing options and more sophisticated techniques can pose a challenge to physicians who are tasked with choosing the best option for their patient, as well as integrating data from multiple tests for clinical decision making. These challenges underscore the growing need for advanced multimodality imaging specialists, as well as the need to educate general cardiologists and trainees on the strengths and limitation of various imaging tests and how to apply them to patient care. This article will provide an overview on how to educate trainees in multimodality imaging and how multimodality imaging can be effectively delivered. ### Defining multimodality imaging and its applications The premise of multimodality cardiovascular imaging is based on using a patient-centred approach to select the best available imaging test when evaluating patients with known or suspected cardiovascular disease. While many clinical questions can be answered by a single test, the effective use of multimodality cardiovascular imaging may require integrating information from various different imaging modalities to answer the clinical question at hand. A key concept in multimodality imaging is patient-centred …