Author + information
- Edward A. Hultena,b,
- Mathew Mercuria,b,
- Thomas Pascuala,b,
- Joao Vitolaa,b,
- Nathan Bettera,b,
- Ganesan Karthikeyana,b,
- John Mahmariana,b,
- Madan Rehania,b,
- Maurizio Dondia,b,
- Diana Paeza,b and
- Andrew Jeffrey Einsteina,b
Background: Although increasing attention has been drawn to medical radiation exposure, little is reported about worldwide variation in nuclear myocardial perfusion imaging (MPI) techniques that may result in differences in radiation exposure. The IAEA Nuclear Cardiology Protocols Study (INCAPS) was initiated to evaluate such differences.
Methods: Observational cross-sectional study of all MPI studies conducted at 308 nuclear cardiology laboratories in 65 countries during a single week in March–April 2013. We evaluated camera technology, reconstruction software and acquisition protocols used and their association with MPI radiation exposure.
Results: 7911 studies were included. Stress only protocols (10% of MPI), rest only protocols (4%), multiple position imaging (7%), attenuation correction (26%), avoidance of thallium (95%), advanced software processing (38%), CZT camera (10%), and PET imaging (6%) were associated with significantly lower radiation dose. Of all lab variables evaluated (Table 1), avoidance of thallium, CZT camera, and stress or rest only protocols had the largest effect size for association with radiation exposure.
Conclusions: Our findings demonstrate variable and overall low worldwide adoption of IAEA recommended best nuclear Cardiology practices. Nearly all sites have succeeded in avoidance of thallium imaging. Adherence to best practices, even low cost solutions such as multiple position imaging, could reduce worldwide radiation exposure during nuclear MPI.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Nuclear Cardiology: Quality
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1246-222
- 2017 American College of Cardiology Foundation