Worldwide Diagnostic Reference Levels for Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging Findings From INCAPS
Por:
Hirschfeld, CB, Dondi, M, Pascual, TNB, Mercuri, M, Vitola, J, Karthikeyan, G, Better, N, Mahmarian, JJ, Bouyoucef, SE, Bom, HHS, Lele, V, Magboo, VPC, Alexanderson, E, Allam, AH, Al-Mallah, MH, Flotats, A, Jerome, S, Kaufmann, PA, Luxenburg, O, Underwood, SR, Rehani, MM, Vassileva, J, Paez, D, Einstein, AJ, INCAPS Investigators Grp
Publicada:
1 mar 2021
Ahead of Print:
19 ago 2020
Resumen:
OBJECTIVES This study sought to establish worldwide and regional diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).
BACKGROUND Reference levels serve as radiation dose benchmarks to compare individual laboratories against aggregated data, helping to identify sites in greatest need of dose reduction interventions. DRLs for SPECT MPI have previously been derived from national or regional registries. To date there have been no muttiregional reports of DRLs for SPECT MPI from a single standardized dataset.
METHODS Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study), a cross-sectional, multinational registry of MPI protocols. A total of 7,103 studies were included. DRLs and AAAs were calculated by protocol for each world region and for aggregated worldwide data.
RESULTS The aggregated worldwide DRLs for rest-stress or stress-rest studies employing technetium Tc 99m-labeled radiopharmaceuticals were 11.2 mCi (first dose) and 32.0 mCi (second dose) for 1-day protocols, and 23.0 mCi (first dose) and 24.0 mCi (second dose) for multiday protocols. Corresponding AAAs were 10.1 mCi (first dose) and 28.0 mCi (second dose) for 1-day protocols, and 17.8 mCi (first dose) and 18.7 mCi (second dose) for multiday protocols. For stress-only technetium Tc 99m studies, the worldwide DRL and AAA were 18.0 mCi and 12.5 mCi, respectively. Stress-first imaging was used in 26% to 92% of regional studies except in North America where it was used in just 7% of cases. Significant differences in DRLs and AAAs were observed between regions.
CONCLUSIONS This study reports reference levels for SPECT MPI for each major world region from one of the largest international registries of clinical MPI studies. Regional DRLs may be useful in establishing or revising guidelines or simply comparing individual laboratory protocols to regional trends. Organizations should continue to focus on establishing standardized reporting methods to improve the validity and comparability of regional DRLs. (C) 2021 by the American College of Cardiology Foundation.
Filiaciones:
Hirschfeld, CB:
Columbia Univ, Dept Med, Irving Med Ctr, New York, NY 10032 USA
NewYork Presbyterian Hosp, New York, NY USA
Dondi, M:
IAEA, Sect Nucl Med & Diagnost Imaging, Div Human Hlth, Vienna, Austria
Pascual, TNB:
IAEA, Sect Nucl Med & Diagnost Imaging, Div Human Hlth, Vienna, Austria
Mercuri, M:
McMaster Univ, Div Emergency Med, Hamilton, ON, Canada
Univ Toronto, Dalla Lana Sch Publ Hlth, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
Vitola, J:
Quanta Diagnost & Terapia, Curitiba, Parana, Brazil
Karthikeyan, G:
All India Inst Med Sci, Dept Cardiol, New Delhi, India
Better, N:
Royal Melbourne Hosp, Dept Nucl Med, Melbourne, Vic, Australia
Univ Melbourne, Melbourne, Vic, Australia
Mahmarian, JJ:
Houston Methodist DeBakey Heart & Vasc Ctr, Dept Cardiol, Houston, TX USA
Bouyoucef, SE:
Ctr Hosp Univ Bab El Oued, Dept Nucl Med, Algiers, Algeria
Bom, HHS:
Chonnam Natl Univ, Dept Nucl Med, Med Sch, Gwangju, South Korea
Lele, V:
Jaslok Hosp & Res Ctr, Dept Nucl Med & PET CT, Mumbai, Maharashtra, India
Magboo, VPC:
Univ Philippines, Dept Phys Sci & Math, Quezon City, Philippines
Univ Santo Tomas Hosp, Dept Nucl Med, Manila, Philippines
Alexanderson, E:
Inst Nacl Cardiol Ignacio Chavez, Dept Cardiol Nucl, Mexico City, DF, Mexico
Univ Nacl Autonoma Mexico, Sch Med, Dept Physiol, Mexico City, DF, Mexico
Allam, AH:
Al Azhar Univ, Cardiol Dept, Cairo, Egypt
Al-Mallah, MH:
Houston Methodist DeBakey Heart & Vasc Ctr, Dept Cardiol, Houston, TX USA
Flotats, A:
Univ Autonoma Barcelona, Nucl Med Dept, Hosp Santa Creu & St Pau, Barcelona, Spain
Jerome, S:
Intersocietal Accreditat Commiss, Ellicott City, MD USA
Univ Maryland, Dept Med, Div Cardiovasc Med, Baltimore, MD 21201 USA
Kaufmann, PA:
Univ Hosp Zurich, Dept Nucl Med & Cardiac Imaging, Zurich, Switzerland
Luxenburg, O:
Minist Hlth, Hlth Informat & Res Directorate, Med Technol, Jerusalem, Israel
Gertner Inst Epidemiol & Hlth Policy Res, Israeli Ctr Technol Assessment Hlth Care, Tel Hashomer, Israel
Underwood, SR:
Imperial Coll London, Natl Heart & Lung Inst, London, England
Royal Brompton Hosp, Dept Nucl Med, London, England
Harefield Hosp, Dept Nucl Med, London, England
Rehani, MM:
Massachusetts Gen Hosp, Dept Radiol, Boston, MA USA
Vassileva, J:
IAEA, Radiat Protect Patients Unit, Vienna, Austria
Paez, D:
IAEA, Sect Nucl Med & Diagnost Imaging, Div Human Hlth, Vienna, Austria
Einstein, AJ:
NewYork Presbyterian Hosp, New York, NY USA
Columbia Univ, Dept Med, Seymour Paul & Gloria Div Cardiol, Irving Med Ctr, New York, NY 10032 USA
Columbia Univ, Dept Radiol, Irving Med Ctr, New York, NY 10032 USA
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