Radiation Dose Reduction Strategies for Nuclear and CT Imaging

Gimelli A, Achenbach S, Buechel RR, et al.
Strategies for Radiation Dose Reduction in Nuclear Cardiology and Cardiac Computed Tomography Imaging: A Report From the European Association of Cardiovascular Imaging (EACVI), the Cardiovascular Committee of European Association of Nuclear Medicine (EANM), and the European Society of Cardiovascular Radiology (ESCR). Eur Heart J 2017;Oct 20:[Epub ahead of print].

The following are 10 points to remember from this report on strategies for radiation dose reduction in nuclear cardiology and cardiac computed tomography (CT) imaging:

  1. Worldwide, 15-20 million myocardial perfusion scans are performed annually.
  2. New technologies for single-photon emission CT (SPECT) such as cadmium-zinc-telluride (CZT) cameras and novel reconstruction methods enable faster scans with lower radiation exposure.
  3. Stress only or stress first imaging can reduce radiation exposures by as much as 75%.
  4. Using prone imaging or attenuation correction techniques can reduce the need for rest perfusion imaging.
  5. Using technetium-99m labelled radiotracers for SPECT can reduce the effective dose of SPECT perfusion imaging by 50%.
  6. Weight-based radiotracer administration can reduce average exposures while maintaining or improving image quality.
  7. Positron emission tomography (PET) myocardial perfusion scans allow for nuclear imaging at extremely low radiation exposures.
  8. Prospective electrocardiography (ECG) triggered for coronary CT scans dramatically reduces radiation exposures compared to retrospective ECG gating.
  9. Lower tube potential (also called voltage) with increased tube current to compensate for noise can further reduce radiation dose from coronary CT without compromising image quality.
  10. It is critical to use imaging tests which involve radiation appropriately, consistent with professional society guidelines. Tests which do not involve ionizing radiation should be used in clinical situations where they offer comparable accuracy.

Clinical Topics: Noninvasive Imaging, Prevention, Stable Ischemic Heart Disease, Computed Tomography, Nuclear Imaging, Chronic Angina

Keywords: Angina, Stable, Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography, Diagnostic Imaging, Electrocardiography, Nuclear Medicine, Primary Prevention, Perfusion Imaging, Positron-Emission Tomography, Radiation Dosage, Radiation, Ionizing, Radionuclide Imaging, Technetium, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed

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