Cardiovascular nuclear imaging: balancing proven clinical value and potential radiation risk

• Published in: Journal of Nuclear Medicine Vol. 52; no. 7; pp. 1162 - 1164
• Format: Journal Article
• Language: English
• Published: United States Society of Nuclear Medicine 01.07.2011
• Subjects: Cancer; Cardiovascular disease; Cardiovascular System - diagnostic imaging; Councils; Diagnostic Imaging - adverse effects; Environmental Exposure - adverse effects; Heart attacks; Humans; Medical imaging; Medicine; Radiation Injuries - etiology; Radionuclide Imaging; Risk assessment
• ISSN: 0161-5505; 1535-5667; 2159-662X
• DOI: 10.2967/jnumed.111.090654

Cardiovascular nuclear medicine studies provide highly sensitive and specific tests that may be indicated for the evaluation of diagnosis, prognosis, and treatment response of coronary artery disease, as well as for selection of patients who benefit from revascularization. RECOMMENDATIONS FOR MINIMIZING RADIATION EXPOSURE AND OPTIMIZING THE CLINICAL USE OF RADIONUCLIDE CARDIAC IMAGING * Adherence to American College of Cardiology/American Heart Association/American Society of Nuclear Cardiology/Society of Nuclear Medicine appropriate-use criteria for radionuclide imaging is recommended. * Radionuclide MPI in asymptomatic low-risk or intermediate-risk individuals with an interpretable electrocardiogram should be avoided as a first test. * Routine use of PET and 99mTc-based SPECT MPI studies instead of protocols with higher radiation exposure should be considered. * Use of nonradioactive, less expensive modalities (e.g., exercise treadmill test) to identify optimal MPI candidates should be considered. * Incorporation of stress-only protocols is encouraged. * Implementation of novel software and hardware with the goal of reducing radiation exposure in accordance with the principle of ALARA is encouraged.