Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).
Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).
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DOI：
10.1093/eurheartj/ehv117
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发表时间：
2015-07-07
影响因子：
39.3
通讯作者：
INCAPS Investigators Group
中科院分区：
文献类型：
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作者：
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
描述来自核心肌灌注成像（MPI）的患者辐射剂量和全球辐射优化“最佳实践”的使用，并评价实验室使用最佳实践与患者辐射剂量之间的关系。我们对2013年3月至4月在65个国家的308个核心脏病学实验室进行的所有7911项MPI研究的方案进行了一项观察性横断面研究。一个专家委员会事先确定了与辐射照射有关的八种“最佳做法”，并设计了一个与辐射有关的质量指数，以表明实验室使用的最佳做法的数量。患者辐射有效剂量（艾德）范围为0.8 - 35.6 mSv（中位数10.0 mSv）。平均实验室艾德范围为2.2 - 24.4 mSv（中位值10.4 mSv）;只有91家（30%）实验室达到指南推荐的中位艾德≤ 9 mSv。实验室QIs范围为2 - 8（中位数5）。艾德和QI在实验室、国家和世界地区之间存在显著差异。欧洲最低的中位艾德（8.0 mSv）与最佳实践的高依从性（平均实验室QI 6.2）一致。最高剂量（中位数12.1 mSv）和低QI（4.9）发生在拉丁美洲。在分层回归模型中，在实验室接受MPI的患者遵循更多的“最佳实践”，ED较低。与MPI相关的辐射安全实践在全球范围内存在显著差异，目前少数实验室实现了目标ED。最佳做法的实施与较低剂量之间的重要关系表明，在全球范围内减少多电离层辐射照射的机会很多。
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. 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. 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.
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DOI：
10.1056/nejmoa0901249
发表时间：
2009-08-27
期刊：
The New England journal of medicine
影响因子：
--
作者：
Fazel R;Krumholz HM;Wang Y;Ross JS;Chen J;Ting HH;Shah ND;Nasir K;Einstein AJ;Nallamothu BK
通讯作者：
Nallamothu BK
影响因子：
--
作者：
Dietze, G;Bartlett, D T;Sato, T
通讯作者：
Sato, T
影响因子：
39.3
作者：
Knuuti, Juhani;Bengel, Frank;Hesse, Birger
通讯作者：
Hesse, Birger
影响因子：
24
作者：
Jaarsma, Caroline;Leiner, Tim;Schalla, Simon
通讯作者：
Schalla, Simon
影响因子：
37.8
作者：
Moran AE;Forouzanfar MH;Roth GA;Mensah GA;Ezzati M;Murray CJ;Naghavi M
通讯作者：
Naghavi M