Gated Myocardial Perfusion SPECT In Australia

摘要

Introduction: Despite guidelines provided by the SNM and the ASNC, there is no universally accepted consensus on acquisition and processing protocols for gated myocardial perfusion SPECT. Anecdotal evidence suggests there is significant variability in both acquisition and processing parameters throughout Australian departments.Methodology: This study was a self administered questionnaire of current acquisition and processing parameters utilised for gated myocardial perfusion SPECT across Australia. The sampling frame comprised 136 Nuclear Medicine departments across Australia including all departments accredited by the ANZSNM.Results: With respect to the guidelines for performing gated myocardial perfusion SPECT outlined by the ASNC, only 4.4% (4/90) of Australian departments comply with minimum standards. The magnitude of this result, in a large part, is due to the high proportion of departments that do not gate both the rest and stress studies (68.9%). Exclusion of this parameter still means that just 13.3% (12/90) of Australian departments comply with minimum standards. Conclusion: While the principle of gated myocardial perfusion SPECT is without debate there is a requirement for investigation and guidelines for optimisation of gated myocardial perfusion SPECT protocols. There is a need for further investigation of the actual impact of discordance with current guidelines on the diagnostic utility of gated myocardial perfusion SPECT. Introduction Each year in Australia, approximately 55000 myocardial perfusions studies are performed (1) because it is the key non invasive procedure that is in widespread use for the investigation of known or suspected CAD. In recent years there have been numerous advances in the technology, science and methodology utilised in performing myocardial perfusion studies in Nuclear Medicine. The emergence of 99mTc based radiopharmaceuticals combined with advances in technology have been responsible for the transition from planar imaging, to single photon emission computed tomography (SPECT) and more recently to gated SPECT. For gated myocardial perfusion SPECT studies, imaging time is not increased (compared with ungated) and a traditional ungated image data set can be produced from the gated data set without compromising normal study quality. Processing time and memory required is, however, substantially increased (by a factor equal to the number of gate intervals) which means older computer systems may be inadequate for gated myocardial perfusion SPECT studies.Despite guidelines provided by the Society of Nuclear Medicine (SNM) (2) and the American Society of Nuclear Cardiology (ASNC) (3), there is no universally accepted consensus on acquisition and processing protocols in gated myocardial perfusion SPECT. Anecdotal evidence suggests there is significant variability in both acquisition and processing parameters throughout Australian departments. This questionnaire aimed to outline current procedure and practice for gated myocardial perfusion SPECT in Australia and identify areas requiring further investigation. Methodology This study was a survey of current acquisition and processing parameters utilised for gated myocardial perfusion SPECT throughout Australia. The study design employed a self administered questionnaire, ensuring participant anonymity. The sampling frame included 136 Australian Nuclear Medicine departments. All departments accredited by the ANZSNM were included. A reply paid envelope was included for the return of the completed questionnaire. The statistical significance was calculated using Chi square analysis for nominal data and Student’s t test for continuous data. The F test analysis of variances was used to determine statistically significant differences within grouped data. A P value less than 0.05 was considered significant. The difference between independent means and proportions was calculated with a 95% confidence interval (CI). Results The collection period saw 75 of