ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine Endorsed by the American College of Emergency Physicians
ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine Endorsed by the American College of Emergency Physicians
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DOI：
10.1016/j.jacc.2009.02.013
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发表时间：
2009-06-09
影响因子：
24
通讯作者：
Williams, Kim A.
中科院分区：
文献类型：
--
作者：
Hendel, Robert C.;Berman, Daniel S.;Williams, Kim A.
美国心脏病学会基金会(ACCF)与主要专科和专科学会一起，对经常考虑心脏放射性核素成像(RNI)的常见临床方案进行了适当的用途审查。本文件是对4年前发布的原始单光子发射计算机断层扫描心肌灌注成像(SPECT MPI)适宜性标准(1)的修订，以反映测试使用和新的临床数据的变化，并澄清原始标准中存在遗漏或不清楚的地方的RNI使用。这与经常修订和完善适当的使用标准(AUC)的承诺是一致的。这次审查的适应症来自于常见的应用或预期的用途，以及当前的临床实践指南。67个临床方案由一个写作小组开发，并由一个单独的技术小组进行评分，从1到9表示适当使用、不适当使用或不确定使用。总的来说，使用心脏RNI诊断和评估中高风险冠心病(CAD)患者的风险，而对低风险患者的测试、常规重复测试和某些临床方案中的一般筛查则不太赞成。此外，围术期测试的使用被发现是不合适的，除非是高选择的患者组。预计这些结果将对医生的决策、测试表现和报销政策产生重大影响，并将有助于指导未来的研究。
The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac radionuclide imaging (RNI) is frequently considered. This document is a revision of the original Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI) Appropriateness Criteria (1), published 4 years earlier, written to reflect changes in test utilization and new clinical data, and to clarify RNI use where omissions or lack of clarity existed in the original criteria. This is in keeping with the commitment to revise and refine appropriate use criteria (AUC) on a frequent basis.The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Sixty-seven clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use.In general, use of cardiac RNI for diagnosis and risk assessment in intermediate- and high-risk patients with coronary artery disease (CAD) was viewed favorably, while testing in low-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Additionally, use for perioperative testing was found to be inappropriate except for high selected groups of patients. It is anticipated that these results will have a significant impact on physician decision making, test performance, and reimbursement policy, and will help guide future research.