부산대학교 도서관

Background: There is growing concern about radiation exposure from nuclear myocardial perfusion imaging (MPI), particularly among younger patients who are more prone to develop untoward effects of radiation. Professional society guidelines recommend age as a consideration in weighing radiation risk. The aim of this analysis is to determine how patient radiation doses from MPI vary across age groups in a large contemporary international cohort.Methods: Data were collected as part of a global cross-sectional study of centers performing MPI coordinated by the International Atomic Energy Agency (IAEA). Sites provided information on laboratory practices and clinical characteristics for each MPI study completed during a single week in March-April 2013. Radiation was quantified by effective dose (ED), a whole-body measure reflecting the amount of radiation to each organ and its relative sensitivity to radiation’s deleterious effects. The primary outcome of this analysis is median ED across age groups. We also studied laboratory adherence to radiation related best practices prespecified by an IAEA expert panel, e.g. avoiding thallium or dual isotope stress, limiting isotope dose and use of weight based dosing, stress-only imaging and camera based dose reduction strategies.Results: Among 7,911 patients undergoing MPI in 308 laboratories in 65 countries, mean ED was 10.0±4.5mSv with slightly higher exposure among younger age groups (trend p value <0.001). Worldwide, nearly 35% of laboratories had median ED≤9mSv, but there were no differences in the proportion of patients with ED ≤9mSv across the different age groups (Table). In addition, there was no difference in adherence to best practices based on the median age of the patients in the labs.Conclusions: Our analysis suggests that in contemporary nuclear cardiology practice, the age of the patient appears not to impact protocol selection and consequently radiation dose, contrary to professional society guidelines.