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@article{Hirschfeld:2021:10.1016/j.jcmg.2020.06.029,
author = {Hirschfeld, CB and Dondi, M and Pascual, TNB and Mercuri, M and Vitola, J and Karthikeyan, G and Better, N and Mahmarian, JJ and Bouyoucef, SE and Hee-Seung, Bom H and Lele, V and Magboo, VPC and Alexánderson, E and Allam, AH and Al-Mallah, MH and Flotats, A and Jerome, S and Kaufmann, PA and Luxenburg, O and Underwood, SR and Rehani, MM and Vassileva, J and Paez, D and Einstein, AJ and INCAPS, Investigators Group},
doi = {10.1016/j.jcmg.2020.06.029},
journal = {JACC: Cardiovascular Imaging},
pages = {657--665},
title = {Worldwide diagnostic reference levels for single-photon emission computed tomography myocardial perfusion imaging: findings from INCAPS.},
url = {http://dx.doi.org/10.1016/j.jcmg.2020.06.029},
volume = {14},
year = {2021}
}

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TY  - JOUR
AB  - OBJECTIVES: This study sought to establish worldwide and regional diagnostic reference levels (DRLs) and achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). BACKGROUND: Reference levels serve as radiation dose benchmarks to compare individual laboratories against aggregated data, helping to identify sites in greatest need of dose reduction interventions. DRLs for SPECT MPI have previously been derived from national or regional registries. To date there have been no multiregional reports of DRLs for SPECT MPI from a single standardized dataset. METHODS: Data were submitted voluntarily to the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study), a cross-sectional, multinational registry of MPI protocols. A total of 7,103 studies were included. DRLs and AAAs were calculated by protocol for each world region and for aggregated worldwide data. RESULTS: The aggregated worldwide DRLs for rest-stress or stress-rest studies employing technetium Tc 99m-labeled radiopharmaceuticals were 11.2 mCi (first dose) and 32.0 mCi (second dose) for 1-day protocols, and 23.0 mCi (first dose) and 24.0 mCi (second dose) for multiday protocols. Corresponding AAAs were 10.1 mCi (first dose) and 28.0 mCi (second dose) for 1-day protocols, and 17.8 mCi (first dose) and 18.7 mCi (second dose) for multiday protocols. For stress-only technetium Tc 99m studies, the worldwide DRL and AAA were 18.0 mCi and 12.5 mCi, respectively. Stress-first imaging was used in 26% to 92% of regional studies except in North America where it was used in just 7% of cases. Significant differences in DRLs and AAAs were observed between regions. CONCLUSIONS: This study reports reference levels for SPECT MPI for each major world region from one of the largest international registries of clinical MPI studies. Regional DRLs may be useful in establishing or revising guidelines or simply comparing individual laboratory
AU  - Hirschfeld,CB
AU  - Dondi,M
AU  - Pascual,TNB
AU  - Mercuri,M
AU  - Vitola,J
AU  - Karthikeyan,G
AU  - Better,N
AU  - Mahmarian,JJ
AU  - Bouyoucef,SE
AU  - Hee-Seung,Bom H
AU  - Lele,V
AU  - Magboo,VPC
AU  - Alexánderson,E
AU  - Allam,AH
AU  - Al-Mallah,MH
AU  - Flotats,A
AU  - Jerome,S
AU  - Kaufmann,PA
AU  - Luxenburg,O
AU  - Underwood,SR
AU  - Rehani,MM
AU  - Vassileva,J
AU  - Paez,D
AU  - Einstein,AJ
AU  - INCAPS,Investigators Group
DO  - 10.1016/j.jcmg.2020.06.029
EP  - 665
PY  - 2021///
SN  - 1876-7591
SP  - 657
TI  - Worldwide diagnostic reference levels for single-photon emission computed tomography myocardial perfusion imaging: findings from INCAPS.
T2  - JACC: Cardiovascular Imaging
UR  - http://dx.doi.org/10.1016/j.jcmg.2020.06.029
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32828783
UR  - https://www.sciencedirect.com/science/article/pii/S1936878X20306057?via%3Dihub
UR  - http://hdl.handle.net/10044/1/82221
VL  - 14
ER  -

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