Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)
Por:
Einstein, AJ, Pascual, TNB, Mercuri, M, Karthikeyan, G, Vitola, JV, Mahmarian, JJ, Better, N, Bouyoucef, SE, Bom, HHS, Lele, V, Magboo, VPC, Alexanderson, E, Allam, AH, Al-Mallah, MH, Flotats, A, Jerome, S, Kaufmann, PA, Luxenburg, O, Shaw, LJ, Underwood, SR, Rehani, MM, Kashyap, R, Paez, D, Dondi, M, Karthikeyan, G, Mercuri, M, Allam, A, Bom, H, Mahmarian, J, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, HJ, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-Nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Meeks, JB, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, SA, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, I, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, R, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, TMC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Cruz, AF, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez, P, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo, T, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, CL, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, McGrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, Weale, J
Publicada:
7 jul 2015
Resumen:
Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose.
Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED <= 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more 'best practices' had lower EDs.
Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally.
Filiaciones:
Einstein, AJ:
Columbia Univ, Med Ctr, Dept Med, Div Cardiol, New York, NY 10027 USA
New York Presbyterian Hosp, New York, NY USA
Columbia Univ, Med Ctr, Dept Radiol, New York, NY USA
Pascual, TNB:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, A-1400 Vienna, Austria
Mercuri, M:
Columbia Univ, Med Ctr, Dept Med, Div Cardiol, New York, NY 10027 USA
New York Presbyterian Hosp, New York, NY USA
Karthikeyan, G:
All India Inst Med Sci, Dept Cardiol, New Delhi, India
Vitola, JV:
Quanta Diagnost & Terapia, Curitiba, Parana, Brazil
Mahmarian, JJ:
Houston Methodist DeBakey Heart & Vasc Ctr, Dept Cardiol, Houston, TX USA
Better, N:
Royal Melbourne Hosp, Dept Nucl Med, Melbourne, Vic, Australia
Univ Melbourne, Melbourne, Vic, Australia
Bouyoucef, SE:
Ctr Hosp Univ Bab El Oued, Algiers, Algeria
Bom, HHS:
Chonnam Natl Univ, Sch Med, Dept Nucl Med, Kwangju, South Korea
Lele, V:
Jaslok Hosp & Res Ctr, Dept Nucl Med & PET CT, Bombay, Maharashtra, India
Magboo, VPC:
Univ Philippines, Dept Phys Sci & Math, Quezon City 1101, Philippines
Univ Santo Tomas Hosp, Dept Nucl Med, Manila, Philippines
Alexanderson, E:
Inst Nacl Cardiol Ignacio Chavez, Dept Cardiol Nucl, Mexico City, DF, Mexico
Allam, AH:
Al Azhar Univ, Dept Cardiol, Cairo, Egypt
Al-Mallah, MH:
King Saud bin Abdulaziz Univ Hlth Sci, Div Adv Cardiac Imaging, Riyadh, Saudi Arabia
Flotats, A:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Nucl Med, E-08193 Barcelona, Spain
Jerome, S:
Intersocietal Accreditat Commiss, Ellicott City, MD USA
Univ Maryland, Div Cardiol, Baltimore, MD 21201 USA
Kaufmann, PA:
Univ Zurich Hosp, Dept Nucl Med & Cardiac Imaging, CH-8091 Zurich, Switzerland
Luxenburg, O:
Minist Hlth, Med Technol & Infrastruct Adm, Jerusalem, Israel
Gertner Inst Epidemiol & Hlth Policy Res, Israeli Ctr forTechnol Assessment Hlth Care, Tel Hashomer, Israel
Shaw, LJ:
Emory Univ, Sch Med, Dept Med, Div Cardiol, Atlanta, GA USA
Emory Univ, Sch Med, Emory Clin Cardiovasc Res Inst, Atlanta, GA USA
Underwood, SR:
Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London SW7 2AZ, England
Royal Brompton & Harefield Hosp, Dept Nucl Med, London, England
Rehani, MM:
IAEA, Radiat Protect Patients Unit, A-1400 Vienna, Austria
Kashyap, R:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, A-1400 Vienna, Austria
Paez, D:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, A-1400 Vienna, Austria
Dondi, M:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, A-1400 Vienna, Austria
Karthikeyan, G:
All India Inst Med Sci, Dept Cardiol, New Delhi, India
Mercuri, M:
Columbia Univ, Med Ctr, Dept Med, Div Cardiol, New York, NY 10027 USA
New York Presbyterian Hosp, New York, NY USA
Allam, A:
Al Azhar Univ, Dept Cardiol, Cairo, Egypt
Bom, H:
Chonnam Natl Univ, Sch Med, Dept Nucl Med, Kwangju, South Korea
Mahmarian, J:
Houston Methodist DeBakey Heart & Vasc Ctr, Dept Cardiol, Houston, TX USA
Vitola, J:
Quanta Diagnost & Terapia, Curitiba, Parana, Brazil
Green Published, Green Submitted, hybrid
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