Worldwide Variation in the Use of Nuclear Cardiology Camera Technology, Reconstruction Software, and Imaging Protocols
Por:
Hirschfeld, CB, Mercuri, M, Pascual, TNB, Karthikeyan, G, Vitola, JV, Mahmarian, JJ, Better, N, Bouyoucef, SE, Bom, HHS, Lele, V, Magboo, VPC, Alexanderson, E, Allam, AH, Al-Mallah, MH, Dorbala, S, Flotats, A, Jerome, S, Kaufmann, PA, Luxenburg, O, Shaw, LJ, Underwood, SR, Rehani, MM, Paez, D, Dondi, M, Einstein, AJ
Publicada:
1 sep 2021
Ahead of Print:
1 sep 2021
Resumen:
OBJECTIVES This study sought to describe worldwide variations in the use of myocardial perfusion imaging hardware, software, and imaging protocols and their impact on radiation effective dose (ED). BACKGROUND Concerns about long-term effects of ionizing radiation have prompted efforts to identify strategies for dose optimization in myocardial perfusion scintigraphy. Studies have increasingly shown opportunities for dose reduction using newer technologies and optimized protocols. METHODS Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study) registry, a multinational, cross-sectional study comprising 7,911 imaging studies from 308 labs in 65 countries. The study compared regional use of camera technologies, advanced post-processing software, and protocol characteristics and analyzed the influence of each factor on ED. RESULTS Cadmium-zinc-telluride and positron emission tomography (PET) cameras were used in 10% (regional range 0% to 26%) and 6% (regional range 0% to 17%) of studies worldwide. Attenuation correction was used in 26% of cases (range 10% to 57%), and advanced post-processing software was used in 38% of cases (range 26% to 64%). Stress-first single-photon emission computed tomography (SPECT) imaging comprised nearly 20% of cases from all world regions, except North America, where it was used in just 7% of cases. Factors associated with lower ED and odds ratio for achieving radiation dose <-9 mSv included use of cadmium-zinc-telluride, PET, advanced post-processing software, and stress-or rest-only imaging. Overall, 39% of all studies (97% PET and 35% SPECT) were <-9 mSv, while just 6% of all studies (32% PET and 4% SPECT) achieved a dose <-3 mSv. CONCLUSIONS Newer-technology cameras, advanced software, and stress-only protocols were associated with reduced ED, but worldwide adoption of these practices was generally low and varied significantly between regions. The imple-mentation of dose-optimizing technologies and protocols offers an opportunity to reduce patient radiation exposure across all world regions. (J Am Coll Cardiol Img 2021;14:1819-1828) (c) 2021 by the American College of Cardiology Foundation.
Filiaciones:
Hirschfeld, CB:
Columbia Univ, Irving Med Ctr, New York Presbyterian Hosp, Dept Med, New York, NY USA
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
Pascual, TNB:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, Vienna, Austria
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:
Univ Melbourne, Dept Nucl Med, Melbourne, Vic, Australia
Royal Melbourne Hosp, Melbourne, Vic, Australia
Bouyoucef, SE:
Univ Bab El Oued, Ctr Hosp, Algiers, Algeria
Bom, HHS:
Chonnam Natl Univ, Med Sch, Dept Nucl Med, 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, Manila, 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, Cardiol Dept, Cairo, Egypt
Al-Mallah, MH:
Houston Methodist DeBakey Heart & Vasc Ctr, Dept Cardiol, Houston, TX USA
Dorbala, S:
Brigham & Womens Hosp, Dept Radiol, Div Nucl Med, 75 Francis St, Boston, MA 02115 USA
Flotats, A:
Univ Autonoma Barcelona, Hosp Santa Creu i St Pau, Nucl Med Dept, 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, Zurich, Switzerland
Luxenburg, O:
Minist Hlth, Med Technol Hlth Informat & Res Directorate, Jerusalem, Israel
Israeli Ctr Technol Assessment Hlth Care, Gertner Inst Epidemiol & Hlth Policy Res, Tel Hashomer, Israel
Shaw, LJ:
New York Presbyterian Weill Cornell Med Ctr, New York, NY USA
Underwood, SR:
Imperial Coll London, Natl Heart & Lung Inst, London, England
Royal Brompton & Harefield Hosp, Dept Nucl Med, London, England
Rehani, MM:
Massachusetts Gen Hosp, Harvard Med Sch, Dept Radiol, Boston, MA 02114 USA
Paez, D:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, Vienna, Austria
Dondi, M:
IAEA, Div Human Hlth, Sect Nucl Med & Diagnost Imaging, Vienna, Austria
Einstein, AJ:
Columbia Univ, Irving Med Ctr, New York Presbyterian Hosp, Dept Med,Seymour Paul & Gloria Div Cardiol, New York, NY USA
Columbia Univ, Irving Med Ctr, New York Presbyterian Hosp, Dept Radiol, New York, NY USA
Green Submitted
|