Current worldwide nuclear cardiology practices and radiation exposure

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. We conducted an observational cross-...

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Detalles Bibliográficos
Autores: Einstein, Andrew J., Pascual, Thomas N. B., Mercuri, Mathew, Karthikeyan, Ganesan, Vitola, João V., Mahmarian, John J., Better, Nathan, Bouyoucef, Salah E., Hee-Seung Bom, Henry, Lele, Vikram, Magboo, V. Peter C., Alexánderson, Erick, Allam, Adel H., Al-Mallah, Mouaz H.|||0000-0003-2348-0484, Flotats, Albert|||0000-0002-0469-827X, Jerome, Scott, Kaufmann, Philipp A., Luxenburg, Osnat, Shaw, Leslee J., Underwood, S. Richard, Rehani, Madan M., Kashyap, Ravi, Paez, Diana, Dondi, Maurizio
Tipo de recurso: artículo
Fecha de publicación:2015
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:185312
Acceso en línea:https://ddd.uab.cat/record/185312
https://dx.doi.org/urn:doi:10.1093/eurheartj/ehv117
Access Level:acceso abierto
Palabra clave:Nuclear cardiology
SPECT
PET
Radiation dose
Best practices
Quality of care
Descripción
Sumario: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. 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. 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.

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