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Nuclear cardiology in the UK: British Nuclear Cardiology Society survey 1994
D J Pennell1, E Prvulovich, A Tweddel
1Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
Insights
Nuclear cardiology practice in the UK increased significantly since 1988, with myocardial perfusion imaging (MPI) rising sharply. However, overall activity remains low compared to Europe and the USA, requiring further investment and training.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Nuclear cardiology practice in the UK was surveyed in 1994 to assess current activity levels and trends.
- Previous surveys indicated a need to evaluate the growth of myocardial perfusion imaging (MPI) and radionuclide ventriculography (RNV).
Purpose of the Study:
- To survey the current practice of nuclear cardiology in the UK in 1994.
- To compare activity levels between regional and district general hospitals.
- To assess trends in MPI and RNV performance and compare UK activity with international benchmarks.
Main Methods:
- A questionnaire was distributed to 219 UK centres performing nuclear imaging.
- 192 centres (88%) responded, providing data on nuclear cardiology activity, technical parameters, and referral sources.
- Data were analyzed to compare activity between hospital types and track changes since 1988.
Main Results:
- 65% of responding centres (125) performed nuclear cardiology.
- Regional centres performed a higher proportion of nuclear cardiology procedures than district general hospitals (85% vs 55%).
- Total nuclear cardiology activity was 0.82 scans/1000/year (MPI: 0.56, RNV: 0.26). MPI increased by 350% since 1988, while RNV fell by 47%.
Conclusions:
- Nuclear cardiology activity, particularly MPI, has significantly increased in the UK since 1988 but remains below national targets and international averages.
- Further investment in equipment, staff, and clinical understanding, including integration into cardiology training, is crucial to meet demand and improve patient care.
Abstract:
This study surveyed practice in nuclear cardiology in the UK in 1994. A questionnaire was sent to 219 centres performing nuclear imaging asking for details of current practice in nuclear cardiology. Replies were received from 192 centres (88%). Activity in performance of myocardial perfusion imaging (MPI) and radionuclide ventriculography (RNV), anticipated changes in activity, differences between regional and district general hospitals, technical imaging parameters and referral sources were surveyed. Of the responding centres, 125 (65%) performed nuclear cardiology. More regional centres (85 vs 55%, P < 0.0003) performed a higher proportion (62 vs 24%, P < 0.001) of nuclear cardiology activity compared with district general hospitals. Nuclear medicine activity was estimated at 9.3 scans/1000/year, of which 8.9% was cardiology (0.82/1000/year; MPI, 0.56/1000/year; RNV, 0.26/1000/year). A comparison with previous surveys showed a significant increase of 24% in nuclear cardiology since 1988, with a strong rise in MPI (350%); however, RNV has fallen by 47%. Myocardial perfusion activity in the UK remains very low (25 and 5% for MPI and RNV respectively) when compared with the average of 2.2/1000/year for Europe and 10.8/1000/year for the USA. In conclusion, MPI has increased on average by 23% per annum (compound rate) since 1988, but in 1994 was still only 32% of the British Cardiac Society target of 2.6 scans/1000/year. Proper resourcing for capital expenditure on new equipment and new staff will be important to maintain momentum in closing the gap. Also important is clinical understanding, as already implemented by including nuclear cardiology in guidelines for specialist cardiology training.