Abstract
There are interesting differences between the practice of Nuclear Cardiology in Japan and that in the United States and associated unique challenges. Differences in patient body habitus and the perceived importance of limiting patient radiation dose have resulted in different radiopharmaceutical and imaging protocol preferences. Governmental approval and reimbursement policies for various radiopharmaceuticals have promulgated adoption of different clinical applications. Both countries have experienced a significant decline in the number of nuclear cardiology studies performed, in part due to decreased governmental funding and reimbursement and to the emergence of competing modalities. Whereas precertification and test substitution have impacted negatively on the sustainability and growth of nuclear cardiology in the United States, in Japan those deterrents have not yet been encountered. Instead, communication barriers between nuclear medicine physicians and referring cardiologists are cited as a more significant barrier.
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Abbreviations
- 123I BMIPP:
-
Iodine-123-beta-methyl-p-iodophenylpentadecanoic acid
- 123I MIBG:
-
Iodine-123-meta-iodobenzylguanidine
- ABNM:
-
American Board of Nuclear Medicine
- ABIM:
-
American Board of Internal Medicine
- ACR:
-
American College of Radiology
- ASNC:
-
American Society of Nuclear Cardiology
- CABG:
-
Coronary artery bypass grafting
- CT:
-
Computed tomography
- CTA:
-
Computed tomography coronary angiography
- DPC:
-
Diagnostic procedure combination
- DRG:
-
Diagnostic related group
- ECG:
-
Electrocardiogram
- FAME:
-
Fractional flow reserve versus angiography for guiding percutaneous coronary intervention
- GDP:
-
Gross domestic product
- JROAD:
-
Japanese Registry of All Cardiac and Vascular Diseases
- JCS:
-
Japanese Circulation Society
- IAC:
-
International Accreditation Council
- JMHLW:
-
Japanese Ministry of Health, Labor and Welfare
- MPI:
-
Myocardial perfusion imaging
- PCI:
-
Percutaneous coronary intervention
- PET:
-
Positron emission tomography
- RBM:
-
Radiology business manager
- SPECT:
-
Single-photon emission computed tomography
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Acknowledgments
I would like to acknowledge the contribution of Dr Tokuo Kasai, who provided much valuable insight into the practice of nuclear cardiology in Japan and who translated documents from Japanese into English for my review.
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Sources of funding—None. Conflict of interest—None.
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This article is co-published in the Journal of Nuclear Cardiology and the Annals of Nuclear Cardiology.
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DePuey, E.G. Comparisons and contrasts in the practice of nuclear cardiology in the United States and Japan. J. Nucl. Cardiol. 23, 1493–1498 (2016). https://doi.org/10.1007/s12350-016-0656-3
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DOI: https://doi.org/10.1007/s12350-016-0656-3