Nuclear Cardiology Practices and Radiation Exposure in the Oceania Region: Results From the IAEA Nuclear Cardiology Protocols Study (INCAPS)

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• 作者：Sinjini Biswas ; MBBS ; BMedSc^a ; ^{sinjini@gmail.com} ; Nathan Better ; MBBS ; FRACP^a ; Thomas N.B. Pascual ; MD^b ; Mathew Mercuri ; PhD^c ; Joã ; o V. Vitola ; MD ; PhD^d ; Ganesan Karthikeyan ; MBBS ; MD ; DM ; MSc^e ; James Westcott ; BAppSc(MedRad)^a ; Erick Alexá ; nderson ; MD^f ; Adel H. Allam ; MD^g ; Mouaz H. Al-Mallah ; MD ; MS^h ; Henry Hee-Seung Bom ; MD ; PhDⁱ ; Salah E. Bouyoucef ; MD^j ; Albert Flotats ; MD^k ; Scott Jerome ; DO^l ; ^m ; Philip A. Kaufman ; MDⁿ ; Vikram Lele ; MD^o ; Osnat Luxenburg ; MD ; MPH ; MBA^p ; ^q ; John J. Mahmarian ; MD^r ; Leslee J. Shaw ; PhD^s ; S. Richard Underwood ; DM ; FRCP^t ; ^u ; Madan Rehani ; PhD^v ; ^w ; Ravi Kashyap ; MD^b ; Maurizio Dondi ; MD^b ; Diana Paez ; MD^b ; Andrew J. Einstein ; MD ; PhD^c ; ^x ; for the INCAPS Investigators Group
• 关键词：Myocardial perfusion imaging ; Radiation exposure
• 刊名：Heart, Lung and Circulation
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：26
• 期：1
• 页码：25-34
• 全文大小：1042 K
• 卷排序：26

文摘

There is concern about radiation exposure with radionuclide myocardial perfusion imaging (MPI). This sub-study of the International Atomic Energy Agency (IAEA) Nuclear Cardiology Protocols Study reports radiation doses from MPI, and use of dose-optimisation protocols in Australia and New Zealand (ANZ), and compares them with data from the rest of the world.MethodsData were collected from 7911 MPI studies performed in 308 laboratories worldwide in one week in 2013, including 439 MPI studies from 34 ANZ laboratories. For each laboratory, effective radiation dose (ED) and a quality index (QI) score (out of 8) based on pre-specified “best practices” was determined.ResultsIn ANZ patients, ED ranged from 0.9-17.9 milliSievert (mSv). Median ED was similar in ANZ compared with the rest of the world (10.0 (IQR: 6.5-11.7) vs. 10.0 (IQR 6.4-12.6, P=0.15), as were mean QI scores (5.5±0.7 vs. 5.4±1.3, P=0.84). Use of stress-only imaging (17.6% vs. 31.8% of labs, P=0.09) and weight-based dosing of technetium-99m (14.7% vs. 30.3%, P=0.07) was lower in ANZ compared with the rest of the world but this difference was not statistically significant. Median ED was significantly lower in metropolitan versus non-metropolitan laboratories (10.1 mSv vs. 11.6 mSv, P<0.01), although mean QI scores were similar (5.4±0.8 vs. 5.5±0.7, P=0.75).ConclusionAcross ANZ, there is variability in ED from MPI, and use of radiation safety practices, particularly between metropolitan and non-metropolitan laboratories. Overall, ANZ laboratories have a similar median ED to laboratories in the rest of the world.