Large nuclear cardiology laboratory slashes radiation dose by 60% in eight years

A large nuclear cardiology laboratory has slashed its average radiation dose by 60% in eight years, according to new research presented at ICNC 2017 and published in JACC: Cardiovascular Imaging. The study in over 18,000 patients shows dose reductions were achieved despite a large number of obese patients.
Medical societies advocate getting radiation doses as low as is reasonably achievable. There are ways to do this but surveys show that adoption of new technologies, which cost money, and new testing algorithms, which take more physician time, has been slow.
This study assessed the impact on radiation dose of modifying protocols and introducing new hardware (cameras) and post processing software in a large nuclear cardiology laboratory network in Kansas City.
The study included the 18,162 single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) studies performed at all four of the Saint Luke’s Mid America Heart Institute nuclear cardiology laboratories from 1 January 2009 to 30 September 2016. SPECT MPI shows how well blood flows through the muscle of the heart and is primarily performed to diagnose the cause of chest pain or to help manage patients with known coronary artery disease.
Protocols were modified by performing stress-only tests where possible, which saves the radiotracer dose from the rest scan. Stress and rest scans are still required in some patients since shadowing from body parts can look like a lack of blood flow and two scans can clarify the findings. Technetium tracers are now used instead of thallium 100% of the time at one-third of the radiation dose.
Small field of view cameras which have advanced post processing, and a new generation of camera systems which are more sensitive and need less radiotracer injected into the body, have both been introduced. These camera systems are equipped with advanced processing which enhances the nuclear pictures and need less radiation or shorter image acquisition times.

Mid America Heart Institute, Kansas City, MO, USAhttps://www.escardio.org/The-ESC/Press-Office/Press-releases/large-nuclear-cardiology-laboratory-slashes-radiation-dose-by-60-in-eight-years