Abstract
Background
Ionizing radiation generated during medical imaging procedures is a matter of concern. However, the current status of radiopharmaceutical use in stress myocardial perfusion imaging (MPI) and the radiation exposure from these radiopharmaceuticals is unknown in Japan.
Methods and Results
A nationwide survey was conducted from June through July 2016. The questionnaires on the radiopharmaceuticals used and their administered doses during stress MPI were sent to 641 nuclear medicine facilities. The responses were collected from 431 facilities and the effective dose (ED) for an adult with standard body weight was calculated. Forty-three percent of the facilities used only 201TlCl, 35% used only 99mTc radiopharmaceuticals, and the remaining 22% used both. The two main reasons for using 201TlCl instead of 99mTc radiopharmaceuticals were “more familiarity with the usage of 201TlCl than 99mTc radiopharmaceuticals” and “apprehension about increasing the burden of physicians performing tracer injection twice.” The mean ED was 14.0 ± 5.5 mSv (range, 3.9 to 25.2 mSv), which was higher than that reported in other countries.
Conclusions
The ED of stress MPI radiopharmaceuticals in Japan is probably higher than the world standard because more than 50% of the facilities still use 201TlCl. We recommend revising the routine stress MPI protocol to reduce the effects of ionizing radiation.
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Abbreviations
- MPI:
-
Myocardial perfusion imaging
- ASNC:
-
American Society of Nuclear Cardiology
- ED:
-
Effective dose
- J-RIME:
-
The Japan Network for Research and Information on Medical Exposures
- DRL:
-
Diagnostic reference level
- IAEA:
-
International Atomic Energy Agency
- INCAPS:
-
International Atomic Energy Agency Nuclear Cardiology Protocols Cross-Sectional Study
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Acknowledgments
We would like to thank everyone in the nuclear medicine facilities who responded to this survey and to Hiroshi Watanabe, Department of Radiological Technology, Japan Labour Health and Welfare Organization, Yokohama Rosai Hospital, for his valuable advice.
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The authors have indicated that they have no financial conflict of interest.
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All editorial decisions for this article, including selection of reviewers and the final decision, were made by guest editor Nagara Tamaki, MD.
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Otsuka, R., Kubo, N., Miyazaki, Y. et al. Current status of stress myocardial perfusion imaging pharmaceuticals and radiation exposure in Japan: Results from a nationwide survey. J. Nucl. Cardiol. 24, 1850–1855 (2017). https://doi.org/10.1007/s12350-017-0867-2
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DOI: https://doi.org/10.1007/s12350-017-0867-2