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Worldwide Variation in the Use of Nuclear Cardiology Camera Technology, Reconstruction Software, and
Cole B Hirschfeld1, Mathew Mercuri2, Thomas N B Pascual3
1Department of Medicine, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, New York, USA.
Newer myocardial perfusion imaging technologies and protocols can significantly reduce radiation effective dose (ED). However, global adoption remains low and varies by region, highlighting opportunities for widespread dose optimization.
Area of Science:
- Nuclear Cardiology
- Medical Imaging
- Radiation Safety
Background:
- Concerns regarding long-term effects of ionizing radiation necessitate dose optimization in myocardial perfusion scintigraphy.
- Emerging technologies and refined protocols show promise for reducing radiation exposure.
Purpose of the Study:
- To analyze global variations in myocardial perfusion imaging hardware, software, and protocols.
- To assess the impact of these variations on radiation effective dose (ED).
Main Methods:
- Utilized data from the International Atomic Energy Agency Nuclear Cardiology Protocols Study (INCAPS) registry.
- Analyzed 7,911 imaging studies from 308 labs in 65 countries, comparing regional technology and protocol usage.
- Investigated the influence of camera types, post-processing software, and imaging strategies on ED.
Main Results:
- Cadmium-zinc-telluride and PET cameras were used in a small percentage of studies globally.
- Advanced software and attenuation correction showed limited adoption.
- Factors like PET, advanced software, and stress-only protocols correlated with lower ED, with 39% of studies achieving ≤9 mSv.
Conclusions:
- Newer technologies, advanced software, and stress-only protocols are linked to reduced radiation effective dose.
- Worldwide adoption of these dose-reducing practices is low and regionally inconsistent.
- Implementing these strategies presents a significant opportunity to lower patient radiation exposure globally.
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