Cardiac imaging procedures have come under increasing scrutiny as a result of high volume utilization, concerns over inappropriate use, a lack of adherence to quality control and the potential of cancer risks attributable to ionizing radiation exposure. Single-photon emission computed tomography (SPECT) and positron emission tomography myocardial perfusion imaging (MPI) play a central role in coronary artery disease diagnosis, but concerns exist regarding the radiation burden to patients and healthcare providers. Today’s combined rest/stress SPECT MPI studies deliver a radiation dose to the patient of about 12 mSv using standard instrumentation, conventional reconstruction and traditional doses, 10 mCi at rest and 30 mCi at stress, which can be reduced significantly with new instrumentation, software, and optimized imaging protocols. Imaging protocols, advances in camera design, and new software algorithms provide the opportunity to improve study quality, increase laboratory efficiency, and reduce radiation exposure compared to conventional methods without compromising diagnostic accuracy. These advances, along with appropriate patient selection and a patient-centered approach to imaging, provide important opportunities to reduce radiation exposure to patients as well as healthcare providers.
After reading this article, the participant should be able to:
- Compare the radiation exposure associated with different MPI protocols.
- Describe minimizing patient-specific tracer dose in MPI with optimized protocol selection.
- Identify the advantages and disadvantages of technetium-99m–based stress-only imaging.
- Discuss the latest advances in instrumentation and software algorithms that can result in reduced radiation exposure.
Categories: Nuclear Medicine, Radiation Safety/Protection