Current worldwide nuclear cardiology practices and radiation exposure : results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)
Einstein, Andrew J. (Columbia University Medical Center and New York-Presbyterian Hospital)
Pascual, Thomas N. B. (International Atomic Energy Agency)
Mercuri, Mathew (Columbia University Medical Center and New York-Presbyterian Hospital)
Karthikeyan, Ganesan (All India Institute of Medical Sciences (Nova Delhi, Índia))
Vitola, João V. (Quanta Diagnóstico & Terapia)
Mahmarian, John J. (Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX)
Better, Nathan (Royal Melbourne Hospital (Melbourne, Austràlia))
Bouyoucef, Salah E. (Centre Hospitalo-Universitaire de Bab El Ouéd)
Hee-Seung Bom, Henry (Chonnam National University Medical School)
Lele, Vikram (Jaslok Hospital and Research Centre)
Magboo, V. Peter C. (University of Santo Tomas Hospital)
Alexánderson, Erick (Instituto Nacional de Cardiología 'Ignacio Chávez')
Allam, Adel H. (Al Azhar University)
Al-Mallah, Mouaz H. (King Saud bin Abdulaziz University for Health Sciences)
Flotats, Albert (Institut d'Investigació Biomèdica Sant Pau)
Jerome, Scott (University of Maryland)
Kaufmann, Philipp A. (University Hospital Zurich (Suïssa))
Luxenburg, Osnat (Gertner Institute for Epidemiology and Health Policy Research)
Shaw, Leslee J. (Emory University School of Medicine)
Underwood, S. Richard (Royal Brompton Hospital (Londres))
Rehani, Madan M. (Radiation Protection of Patients Unit, International Atomic Energy Agency)
Kashyap, Ravi (International Atomic Energy Agency)
Paez, Diana (International Atomic Energy Agency)
Dondi, Maurizio (International Atomic Energy Agency)
Universitat Autònoma de Barcelona

Fecha:	2015
Resumen:	To 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. We 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. Marked 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.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Nuclear cardiology ; SPECT ; PET ; Radiation dose ; Best practices ; Quality of care
Publicado en:	European heart journal, Vol. 36 (april 2015) , p. 1689-1696, ISSN 1522-9645

DOI: 10.1093/eurheartj/ehv117
PMID: 25898845

8 p, 197.0 KB

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