Radiation exposure from radionuclide myocardial perfusion imaging: Concerns and solutions
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Radionuclide myocardial perfusion imaging (RMPI) is an invaluable tool in the diagnosis and management of coronary artery disease (CAD). However, with the rising use RMPI and other imaging procedures, radiation exposure from these studies has become an increasing concern among health care providers, patients, and policy makers. Recent studies evaluating the extent of radiation exposure and projected cancer risks related to medical imaging have significantly increased the visibility of this issue. The National Council on Radiation Protection and Measurements recently reported a six-fold increase in radiation exposure from medical imaging since 1980.1 Over 20% of all radiation exposure from medical imaging has been attributed to RMPI alone.2 A recent analysis projected that the 9.1 million myocardial perfusion scans performed annually in the United States could result in 7400 additional future cancers.3 In the wake of such reports, Congress has held hearings to investigate th
- National Council on Radiation Protection and Measurements. NCRP Report No. 160, Ionizing Radiation Exposure of the Population of the United States. Bethesda, MD: National Council on Radiation Protection and Measurements; March 2009.
- Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009;361:849-57. CrossRef
- Berrington de Gonzalez A, Kim KP, Smith-Bindman R, McAreavey D. Myocardial perfusion scans: Projected population cancer risks from current levels of use in the United States. Circulation 2010;122:2403-10. CrossRef
- Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 2007;298:317-23. CrossRef
- United States Nuclear Regulatory Commission Regulations (10 CFR) (2011) Subpart B 20.1101-Radiation protection programs. http://www.nrc.gov/reading-rm/doc-collections/cfr/part020/part020-1101.html. Last accessed April 26.
- Jacob K, Vivian G, Steel JR. X-ray dose training: Are we exposed to enough? Clin Radiol 2004;59:928-34. discussion 926-7. CrossRef
- Lee CI, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: Assessment of patient, physician, and radiologist awareness of radiation dose and possible risks. Radiology 2004;231:393-8. CrossRef
- Quinn AD, Taylor CG, Sabharwal T, Sikdar T. Radiation protection awareness in non-radiologists. Br J Radiol 1997;70:102-6.
- Shiralkar S, Rennie A, Snow M, Galland RB, Lewis MH, Gower-Thomas K. Doctors’ knowledge of radiation exposure: Questionnaire study. BMJ 2003;327:371-2. CrossRef
- Dauer LT, Thornton RH, Hay JL, Balter R, Williamson MJ, St Germain J. Fears, feelings, and facts: Interactively communicating benefits and risks of medical radiation with patients. AJR Am J Roentgenol 2011;196:756–61. CrossRef
- Radiation Exposure in X-ray Examinations. Radiological Society of North America (RSNA), March 30, 2007. http://www.radiologyinfo.org/.
- Fazel R, Dilsizian V, Einstein AJ, Ficaro EP, Henzlova M, Shaw LJ. Strategies for defining an optimal risk-benefit ratio for stress myocardial perfusion SPECT. J Nucl Cardiol 2011;18(3):385–92. CrossRef
- Brindis RG, Douglas PS, Hendel RC, Peterson ED, Wolk MJ, Allen JM, et al. ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): A report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association. J Am Coll Cardiol 2005;46:1587-605. CrossRef
- Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. Circulation 2009;119:e561-87. CrossRef
- Patel MR, Spertus JA, Brindis RG, Hendel RC, Douglas PS, Peterson ED, et al. ACCF proposed method for evaluating the appropriateness of cardiovascular imaging. J Am Coll Cardiol 2005;46:1606-13. CrossRef
- Hendel RC, Berman DS, Di Carli MF, Heidenreich PA, Henkin RE, Pellikka PA, et al. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine. J Am Coll Cardiol 2009;53:2201-29. CrossRef
- Hendel RC, Cerqueira M, Douglas PS, Caruth KC, Allen JM, Jensen NC, Pan W, Brindis R, Wolk M. A multicenter assessment of the use of single-photon emission computed tomography myocardial perfusion imaging with appropriateness criteria. J Am Coll Cardiol 2010;55(2):156–62.
- Young LH, Wackers FJ, Chyun DA, Davey JA, Barrett EJ, Taillefer R, et al. Cardiac outcomes after screening for asymptomatic coronary artery disease in patients with type 2 diabetes: The DIAD study: A randomized controlled trial. JAMA 2009;301:1547-55. CrossRef
- Cerqueira MD, Allman KC, Ficaro EP, Hansen CL, Nichols KJ, Thompson RC, et al. Recommendations for reducing radiation exposure in myocardial perfusion imaging. J Nucl Cardiol 2010;17:709-18. CrossRef
- Einstein AJ, Weiner SD, Bernheim A, Kulon M, Bokhari S, Johnson LL, et al. Multiple testing, cumulative radiation dose, and clinical indications in patients undergoing myocardial perfusion imaging. JAMA 2010;304:2137-44. CrossRef
- Radiation exposure from radionuclide myocardial perfusion imaging: Concerns and solutions
Journal of Nuclear Cardiology
Volume 18, Issue 4 , pp 562-565
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors