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Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

Authors :
Einstein, Aj
Pascual, Tn
Mercuri, M
Karthikeyan, G
Vitola, Jv
Mahmarian, Jj
Better, N
Bouyoucef, Se
Hee-Seung Bom, H
Lele, V
Magboo, Vp
Alexánderson, E
Allam, Ah
Al-Mallah, Mh
Flotats, A
Jerome, S
Kaufmann, Pa
Luxenburg, O
Shaw, Lj
Underwood, Sr
Rehani, Mm
Kashyap, R
Paez, D
Dondi, M
INCAPS Investigators Group: Einstein AJ
Alexanderson, E
Allam, A
Bom, H
Mahmarian, J
Vitola, J
Amouri, W
Essabbah, H
Gassama, Ss
Makhdomi, Kb
El Mustapha GI
El Ouchdi, N
Qaïs, N
Soni, N
Vangu, W
Abazid, Rm
Adams, B
Agarwal, V
Alfeeli, Ma
Alnafisi, N
Bernabe, L
Bural, Gg
Chaiwatanarat, T
Chandraguptha, Jm
Cheon, Gj
Cho, I
Dogan, As
Eftekhari, M
Frenkel, A
Garty, I
George, S
Geramifar, P
Golan, H
Habib, S
Hussain, R
Im, H
Jeon, Hj
Kalawat, T
Kang, Wj
Keng, F
Klaipetch, A
Kumar, Pg
Lee, J
Lee, Ww
Lim, I
Macaisa, Cm
Malhotra, G
Mittal, Br
Mohammad, Mh
Mohan, P
Mulyanto, Id
Nariman, D
Nayak, Un
Niaz, K
Nikolov, G
Obaldo, Jm
Ozturk, E
Park, Jm
Park, S
Patel, Cd
Phuong, Hk
Quinon, Ap
Rajini, Tr
Saengsuda, Y
Santiago, J
Sayman, Hb
Shinto, As
Sivasubramaniyan, V
Son, Mh
Sudhakar, P
Syed, Gm
Tamaki, N
Thamnirat, K
Thientunyakit, T
Thongmak, S
Velasco, Dn
Verma, A
Vutrapongwatana, U
Wang, Y
Won, Ks
Yao, Z
Yingsa-nga, T
Yudistiro, R
Yue, Kt
Zafrir, N
Adrian, Sc
Agostini, D
Aguadé, S
Armitage, G
Backlund, M
Backman, M
Baker, M
Balducci, Mt
Bavelaar, C
Berovic, M
Bertagna, F
Beuchel, R
Biggi, A
Bisi, G
Bonini, R
Bradley, A
Brudin, L
Bruno, I
Busnardo, E
Casoni, R
Choudhri, A
Cittanti, C
Clauss, R
Costa, Dc
Costa, M
Dixon, K
Dziuk, M
Egelic, N
Eriksson, I
Fagioli, G
de Faria DB
Florimonte, L
Francini, A
French, M
Gallagher, E
Garai, I
Geatti, O
Genovesi, D
Gianolli, L
Gimelli, A
del Giudice, E
Halliwell, S
Hansson, Mj
Harrison, C
Homans, F
Horton, F
Jędrzejuk, D
Jogi, J
Johansen, A
Johansson, H
Kalnina, M
Kaminek, M
Kiss, A
Kobylecka, M
Kostkiewicz, M
Kropp, J
Kullenberg, R
Lahoutte, T
Lang, O
Larsson, Yh
Lázár, M
Leccisotti, L
Leners, N
Lindner, O
Lipp, Rw
Maenhout, A
Maffioli, L
Marcassa, C
Martins, B
Marzullo, P
Medolago, G
Meeks, Jb
Mendiguchía, Cg
Mirzaei, S
Mori, M
Nardi, B
Nazarenko, S
Nikoletic, K
Oleksa, R
Parviainen, T
Patrina, J
Peace, R
Pirich, C
Piwowarska-Bilska, H
Popa, S
Prakash, V
Pubul, V
Puklavec, L
Rac, S
Ratniece, M
Rogan, Sa
Romeo, A
Rossi, M
Ruiz, D
Sabharwal, N
Salobir, Bg
Santos, Ai
Saranovic, S
Sarkozi, A
Schneider, Rp
Sciagra, R
Scotti, S
Servini, Z
Setti, Lr
Starck, Så
Vajauskas, D
Veselý, J
Vieni, A
Vignati, A
Vito, Im
Weiss, K
Wild, D
Zdraveska-Kochovska, M
Agüro, Rn
Alvarado, N
Barral, Cm
Beretta, M
Berrocal, I
Batista Cuellar JF
Cabral Chang TM
Cabrera Rodríguez LO
Canessa, J
Castro Mora, G
Claudia, Ac
Clavelo, Gf
Cruz Júnior AF
Faccio, Ff
Fernández, Km
Gomez Garibo JR
Gonzalez, U
E P, González
Guzzo, Ma
Jofre, J
Kapitán, M
Kempfer, G
Lopez, Jl
V T, Massardo
Medeiros Colaco, I
Mesquita, Ct
Montecinos, M
Neubauer, S
Pabon, Lm
Puente, A
Rochela Vazquez LM
Serna Macias JA
Silva Pino AG
Tártari Huber FZ
Tovar, Ap
Vargas, L
Wiefels, C
Aljizeeri, A
Alvarez, Rj
Barger, D
Beardwood, W
Behrens, J
Brann, L
Brown, D
Carr, H
Churchwell, K
Comingore, Ga
Corbett, J
Costello, M
Cruz, F
Depinet, T
Dorbala, S
Earles, M
Esteves, Fp
Etherton, E
Fanning RJ Jr
Fornace, J
Franks, L
Gewirtz, H
Gulanchyn, K
Hannah, Cl
Hays, J
Hendrickson, J
Hester, J
Holmes, K
Johnson, A
Jopek, C
Lewin, H
Lyons, J
Manley, C
Meden, J
Moore, S
Moore, Wh
Murthy, V
Nace, R
Neely, D
Nelson, L
Niedermaier, O
Rice, D
Rigs, R
Schiffer, K
Schockling, E
Schultz, T
Schumacker, T
Sheesley, B
Sheikh, A
Siegel, B
Slim, Am
Smith, J
Szulc, M
Tanskersley, N
Tilkemeier, P
Valdez, Gd
Vrooman, R
Wawrowicz, D
Winchester, De
Alcheikh, A
Allen, B
Atkins, E
Bevan, J
Bonomini, C
Christiansen, J
Clack, L
Craig, E
Dixson, H
Duncan, I
Fredericks, S
Gales, S
Hampson, R
Hanley, T
Hartcher, K
Hassall, J
Kelley, B
Kelly, S
Kidd, T
de Kort, T
Larcos, G
Macdonald, W
Mcgrath, C
Murdoch, E
O'Malley, S
O'Rourke, M
Pack, M
Pearce, R
Praehofer, R
Ramsay, S
Scarlett, L
Smidt, K
Souvannavong, F
Taubman, K
Taylor, G
Tse, K
Unger, S
Weale, J.
Source :
Dipòsit Digital de Documents de la UAB, Universitat Autònoma de Barcelona
Publication Year :
2015
Publisher :
Oxford University Press (OUP), 2015.

Abstract

Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally.

Details

Language :
English
Database :
OpenAIRE
Journal :
Dipòsit Digital de Documents de la UAB, Universitat Autònoma de Barcelona
Accession number :
edsair.doi.dedup.....7e801769f2a63b5992f018f21be28e7a