Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the EACVI, EANM, ESCR

European Heart Journal

8 Novembre Nov 2017 15 days ago
  • Pontone G

Cardiovascular diseases (CVDs) are the leading cause of death in Europe (5 million deaths per year) at a cost of €196 billion in 2009. Imaging techniques such as computed tomography (CT), single photon emission computed tomography (SPECT), and positron emission tomography (PET) play an increasingly important role in the diagnosis of CVD.

Regarding myocardial perfusion imaging, scan volume has grown rapidly worldwide over the past two decades to 15–20 million procedures annually and diffusion of technology and expertise has led to its continued adoption across the developing world. However, there are concerns regarding the radiation burden associated with these diagnostic modalities.

During the past 10 years, numerous technologies and data acquisition protocols for low-dose imaging have become available. The implementation of these technologies is always a balance between the long-term risk associated with exposure to ionizing radiation and the short-term risk related to impaired diagnostic accuracy. Furthermore, an important aspect to keep the dose as low as possible is to choose the most appropriate test for an individual patient using the correct acquisition protocol. From a clinical point of view, this implies to select the diagnostic test that is most likely to influence and direct patient care to improve outcome. From a technical point of view, this implies knowledge on differences between protocols and applying the protocol that results in the highest image quality with the lowest radiation exposure. Dose reduction is a multidisciplinary effort.

For this reason, this article provides a consensus of three professional associations in the field of cardiac imaging—the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR)—focusing on the balance between radiation dose and diagnostic accuracy, in agreement with the European guidelines endorsed by the involved associations.

Reference

  • Gimelli A, Achenbach S, Buechel RR, Edvardsen T, Francone M, Gaemperli O, Hacker M, Hyafil F, Kaufmann PA, Lancellotti P, Nieman K, Pontone G, Pugliese F, Verberne HJ, Gutberlet M, Bax JJ, Neglia D; EACVI Scientific Documents Committee. Strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography imaging: a report from the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR). Eur Heart J 2017 Oct 20. doi: 10.1093/eurheartj/ehx582. [Epub ahead of print] Go to PubMed