Observational studyEuropean heart journal2015
Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).
Observational study in European heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
81 citing papers in PubMed, 3 syntheses or guidelines pooled it, 178 citations in OpenAlex.
- Efficiency of tetrofosmin versus sestamibi achieved through shorter injection-to-imaging times: A systematic review of the literature.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Pooled it
- Update of the Brazilian Guideline on Nuclear Cardiology - 2020.Arquivos brasileiros de cardiologia · 2020Guideline
- Radiation Safety in Children With Congenital and Acquired Heart Disease: A Scientific Position Statement on Multimodality Dose Optimization From the Image Gently Alliance.JACC. Cardiovascular imaging · 2017Guideline
- Variability of radiation doses of cardiac diagnostic imaging tests: the RADIO-EVINCI study (RADIationdOse subproject of the EVINCI study).BMC cardiovascular disorders · 2017Trial
- Quantitative and semi-quantitative comparison of myocardial blood flow betweenQuantitative imaging in medicine and surgery · 2026Article
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- Article
- Development and clinical application of biological dosimetry technology: insights from the HICARE/IAEA 2025 international training course.Journal of radiation research · 2026Article
- Cost-effective integration of dynamic myocardial CT perfusion in the assessment of symptomatic coronary artery disease.European radiology · 2026Article
- Current and Emerging Approaches for Primary Prevention of Coronary Artery Disease Using Cardiac Computed Tomography.Current cardiology reports · 2024Review
- Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography.European heart journal. Cardiovascular Imaging · 2024Article
- Clinical phenotypes among patients with normal cardiac perfusion using unsupervised learning: a retrospective observational study.EBioMedicine · 2024Observational
- Association of Income Level and Ischemic Heart Disease: Potential Role of Walkability.Arquivos brasileiros de cardiologia · 2023Article
- Deep learning-based denoising in projection-domain and reconstruction-domain for low-dose myocardial perfusion SPECT.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Preparing for the Artificial Intelligence Revolution in Nuclear Cardiology.Nuclear medicine and molecular imaging · 2023Review
- Quality metrics for single-photon emission computed tomography myocardial perfusion imaging: an ASNC information statement.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Radiation Dose Assessment for Myocardial Perfusion Imaging: A Single Institution Survey.Tomography (Ann Arbor, Mich.) · 2023Article
- Gender Differences in the Impact of Recommendations on Diagnostic Imaging Tests: A Retrospective Study 2007-2021.Life (Basel, Switzerland) · 2023Article
- Optimization ofAnnals of nuclear cardiology · 2023Article
- Patient Selection and Clinical Indication for Chronic Total Occlusion Revascularization-A Workflow Focusing on Non-Invasive Cardiac Imaging.Life (Basel, Switzerland) · 2022Review
21 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
25 authors at 19 institutions in 14 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo 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. METHODS AND
resultsWe 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.
conclusionMarked 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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.