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Research Letter |

Comparison of Radiation Doses and Best-Practice Use for Myocardial Perfusion Imaging in US and Non-US Laboratories Findings From the IAEA (International Atomic Energy Agency) Nuclear Cardiology Protocols Study

Mathew Mercuri, PhD1; Thomas N. B. Pascual, MD2; John J. Mahmarian, MD3; Leslee J. Shaw, PhD4; Madan M. Rehani, PhD5,6; Diana Paez, MD2; Andrew J. Einstein, MD, PhD1,7 ; for the INCAPS Investigators Group
[+] Author Affiliations
1Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York–Presbyterian Hospital, New York, New York
2Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, International Atomic Energy Agency (IAEA), Vienna, Austria
3Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
4Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
5Radiation Protection of Patients Unit, IAEA, Vienna, Austria
6Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston
7Department of Radiology, Columbia University Medical Center, New York–Presbyterian Hospital, New York, New York
JAMA Intern Med. 2016;176(2):266-269. doi:10.1001/jamainternmed.2015.7102.
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This study compares actual myocardial perfusion imaging practice and radiation doses in US and non-US laboratories and identifies opportunities to improve radiation doses in the United States.

Myocardial perfusion imaging (MPI) is integral to the diagnosis and management of known or suspected coronary artery disease1,2 and is therefore performed on millions of US patients each year. However, the associated exposure to ionizing radiation has raised concerns about potential radiation-related health effects. The recent cross-sectional study of MPI practice conducted by the International Atomic Energy Agency (IAEA) demonstrated significant variations in radiation doses, and in the use of best practices that can help to reduce dose, among laboratories worldwide.3 Although survey data have described self-reported US use of different MPI protocols and some dose-reduction methods,4 no previous study, to our knowledge, has characterized actual US MPI radiation doses as well as use of best practices. We compared actual MPI practice and radiation doses in US and non-US laboratories and identified opportunities to improve radiation doses in the United States.

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