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A multicenter evaluation of the appropriate use of single-photon emission tomography myocardial perfusion imaging in Greece

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

This study evaluates the appropriate use of myocardial perfusion imaging (MPI) and determines patterns and variables associated with inappropriate testing.

Methods

Over a 10-month period data were collected prospectively from consecutive patients referred for MPI in four academic departments and an appropriate use grade was assigned (appropriate, uncertain, inappropriate, and unclassifiable scans) according to established criteria.

Results

Among 3,032 referrals appropriate MPI had 72.8% of patients and 19.2% of studies were inappropriate, the remaining being uncertain (7.2%) or unclassifiable (0.8%). In multivariate analysis the asymptomatic status (odds ratio 10.7, P < .001), good functional capacity (odds ratio 1.9, P < .001), an interpretable resting electrocardiogram (odds ratio 1.8, P = .004), an age <65 years (odds ratio 1.5, P = .001) and the absence of diabetes (odds ratio 1.7, P < .001) or dyslipidemia (odds ratio 1.3, P = .014) were independent predictors of inappropriate scintigraphy. The most common indication for inappropriate testing was the assessment of asymptomatic patients <2 years after percutaneous coronary intervention (PCI) (38.9%).

Conclusions

The appropriate use of MPI is relatively high, but a considerable proportion of inappropriate scans is noted which is associated with markers of lower risk. The most common source of inappropriate testing is the assessment of asymptomatic patients <2 years after PCI.

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Authors and Affiliations

  1. Department of Nuclear Medicine, AHEPA University Hospital, Aristotle University Medical School, 1 Stilponos Kyriakidi Str, 54636, Thessaloníki, Greece

    Efstratios Moralidis PhD, Nafsika Papadimitriou MD & Anna Gotzamani-Psarrakou PhD

  2. Department of Nuclear Medicine, Heraklion University Hospital, Crete, Greece

    Maria Stathaki PhD & Nikolaos Karkavitsas PhD

  3. Department of Nuclear Medicine, Ioannina University Hospital, Epirus, Greece

    Xanthi Xourgia MD & Andreas Fotopoulos PhD

  4. Department of Nuclear Medicine, Rio University Hospital, Patras, Peloponnese, Greece

    Tryfon Spyridonidis MD & Dimitrios Apostolopoulos PhD

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  1. Efstratios Moralidis PhD
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  2. Nafsika Papadimitriou MD
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  3. Maria Stathaki PhD
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Correspondence to Efstratios Moralidis PhD.

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Moralidis, E., Papadimitriou, N., Stathaki, M. et al. A multicenter evaluation of the appropriate use of single-photon emission tomography myocardial perfusion imaging in Greece. J. Nucl. Cardiol. 20, 275–283 (2013). https://doi.org/10.1007/s12350-012-9664-0

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  • DOI: https://doi.org/10.1007/s12350-012-9664-0

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