ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2020
Drivers of radiation dose reduction with myocardial perfusion imaging: A large health system experience.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Evaluation of myocardial perfusion imaging techniques and artificial intelligence (AI) tools in coronary artery disease (CAD) diagnosis through multi-criteria decision-making method.Cardiovascular diagnosis and therapy · 2024Article
- Value of Ischemia and Coronary Anatomy in Prognosis and Guiding Revascularization Among Patients With Stable Ischemic Heart Disease.Circulation. Cardiovascular imaging · 2024Article
- Influence of Body Mass Index on Radiation Exposure Across Imaging Modalities in the Evaluation of Chest Pain.Journal of the American Heart Association · 2024Article
- Preclinical PET Imaging and Toxicity Study of aPharmaceutics · 2023Article
- Deep learning, another important tool for improving acquisition efficiency in SPECT MPI Imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Assessing the downstream value of first-line cardiac positron emission tomography (PET) imaging using real world Medicare fee-for-service claims data.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Observational
- Good drivers: Achieving dose reduction across a health care system through implementation of multiple radiation-sparing practices.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Myocardial perfusion stress test: is it worth?The international journal of cardiovascular imaging · 2020Article
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7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundDespite increasing emphasis on reducing radiation exposure from myocardial perfusion imaging (MPI), the use of radiation-sparing practices (RSP) at nuclear laboratories remains limited. Defining real-world impact of RSPs on effective radiation dose (E) can potentially further motivate their adoption.
methodsMPI studies performed between 1/2010 and 12/2016 within a single health system were included. Mean E was compared between sites with 'basic' RSP (defined as elimination of thallium-based protocols and use of stress-only (SO) imaging on conventional single photon emission computed tomography (SPECT) cameras) and those with 'advanced' capabilities (sites that additionally used solid-state detector (SSD) SPECT cameras, advanced post-processing software (APPS) or positron emission tomography (PET) imaging), after matching patients by age, gender, and weight. Contributions of individual RSP to E reduction were determined using multiple linear regression after adjusting for factors affecting tracer dose.
resultsAmong 55,930 MPI studies performed, the use of advanced RSP was associated with significantly lower mean E compared to basic RSP (7 ± 5.6 mSv and 16 ± 5.4 mSv, respectively; P < 0.001), with a greater likelihood of achieving E < 9 mSv (65.7% vs. 10.8%, respectively; OR 15.8 [95% CI 14 to 17.8]; P < 0.0001). Main driver of E reduction was SO-SSD SPECT (mean reduction = 11.5 mSv), followed by use of SO-SPECT + APPS (mean reduction = 10.1 mSv), ;ET (mean reduction = 9.7 mSv); and elimination of thallium protocols (mean reduction = 9.1 mSv); P < 0.0001 for all comparisons.
conclusionIn a natural experiment with implementation of radiation-saving practices at a large health system, stress-only protocols used in conjunction with modern SPECT technologies, the use of PET and elimination of thallium-based protocols were associated with greatest reductions in radiation dose. Availability of several approaches to dose reduction within a health system can facilitate achievement of targeted radiation benchmarks in a greater number of performed studies.
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