Practice of nuclear medicine in Spain

Nuclear cardiology practice in Spain

BACKGROUND

In Spain, nuclear cardiology (NC) procedures represent the second most frequently performed studies in nuclear medicine (NM) centers.

METHODS

The NC Working Group of the Spanish Society of Nuclear Medicine and Molecular Imaging invited NM departments across the country to answer an online questionnaire regarding 2014 activity.

RESULTS

Data on 40,161 patients from 42 centers were collected. The responding public centers served 39% of Spain´s population. The estimated NC activity for public hospitals was 2 studies/1,000 population/year. Of all the NC procedures, 69% were SPECT myocardial perfusion imaging (MPI), 17% equilibrium ventriculography, 12% 18F-FDG PET, 1.3% first pass ventriculography, and <1% innervation and amyloidosis imaging, respectively. The most frequent NC study was a 99mTc tracer, exercise, 2-day MPI ECG-gated SPECT ordered by a cardiologist for diagnosis in an outpatient with 21 days of mean waiting time, the stress phase being supervised by both a cardiologist and a NM physician, with a NM physician writing a complete report.

CONCLUSIONS

A major challenge for NC in Spain is the gradual adoption of high-sensitivity, low-dose-dedicated cardiac SPECT cameras and the broadening of cardiac PET utilization with more cameras, and the availability of MPI tracers alongside the viability/inflammation setup.

Myocardial perfusion scintigraphy in Europe 2005: a survey of the European Council on Nuclear Cardiology

PURPOSE

We have conducted a survey of myocardial perfusion scintigraphy (MPS) in 2005 in Europe with the intention of initiating a regular series of surveys to track usage of the technique.

METHODS

Information was obtained from 234 centres in 18 counties. The returning centres served 27% of the population of their countries, and estimates of the numbers of MPS per million of population (pmp) were made assuming that the population not reported either performed no studies (lower estimate) or the same number pmp as the reporting centres (upper estimate).

RESULTS

Estimates of MPS for the countries surveyed ranged from a lower limit of 373 pmp to an upper limit of 1,388 pmp. There were marked variations between countries with higher numbers (lower limit of estimate above the mid range of all countries combined) in Austria, Greece, Hungary, The Netherlands, Sweden and Slovenia, and lower numbers (upper limit of estimate below the mid range of all countries) in Finland, Germany and Poland. The ratio of MPS to coronary angiography to revascularisation procedures was 0.6 to 1.5 to 1. The median number of studies per centre was 496, with 32% of centres performing fewer than 250 studies in the year. The median waiting time for routine studies was 21 days and for urgent studies 3.4 days. Fifty-three percent of studies used pharmacological stress, with roughly equal numbers of adenosine and dipyridamole. Eighty-two percent of studies used (99m)Tc-based tracers. Tomographic acquisition was almost universal with 65% of studies being ECG-gated and 20% attenuation-corrected. Eighteen percent of studies were reported from hard copy alone, and 60% of studies were reported without viewing the rotating planar data.

CONCLUSION

We conclude that relatively low numbers of MPS studies are being performed in the surveyed centres, particularly when compared with coronary angiography and revascularisation. The use of (99m)Tc-based tracers is high, but ECG-gated studies are less common. Some reporting practices are not ideal. These data will serve as a valuable baseline for future surveys, which are likely to be more complete.

Activity and practice of nuclear cardiology in the Czech Republic, 2001

Radionuclide myocardial perfusion imaging (MPI) has been on the rise in Europe and the USA. Details on nuclear cardiology in the Czech Republic are not available as yet, as it is impossible to obtain comprehensive data from official registers owing to different methods of reporting and data evaluation. A questionnaire concerning nuclear cardiology activity and practice in 2001 was sent to all nuclear medicine departments in the Czech Republic. All 48 departments completed the questionnaire. In 2001, 50 planar and 54 tomographic (SPET) scintillation cameras were used. The average age of the SPET cameras was 5 years (13% of SPET cameras were >8 years old). Out of the 48 centres, 39 (81%) provided a nuclear cardiology service; the total number of cardiological studies was 15,740 in 2001 (1.5 studies/1,000 population/year). The most frequently employed method was MPI (81.7%), the frequency of which had increased by 10% compared with 2000; 26 of the 39 (67%) departments reported that MPI activity was increasing. Nevertheless, the Czech Republic nuclear cardiology activity remained below the European average (2.2/1,000 population in 1994) and, particularly, below activity in the USA (15/1,000 in 1997). The activity was rather unevenly spread. Whereas two centres with >1,000 studies/year accounted for 20% of the total MPI studies, 16 of 39 (41%) departments exhibited low activity (<200 studies/year) and accounted for only 15% of the total MPI studies. The use of SPET increased from 91% in 2000 to 94% in 2001 (only three institutes performed planar examinations). The most widely used tracer was (99m)Tc-MIBI (60% of total MPI), followed by (201)Tl (21%) and (99m)Tc-tetrofosmin (19%). ECG-gated SPET was employed by 20/39 (51%) centres, of which 11 (28%) performed it as a standard examination; 39% of the total MPI studies included this technique. Thirteen percent (5/39) of the departments used attenuation correction, and 69% (27/39) of the departments used a prone projection. Equilibrium radionuclide ventriculography, with 2,317 examinations (14.7%), ranked second among all nuclear cardiology methods, followed by first-pass angiocardiography (406 studies, 2.6%) and (18)F-FDG (163 studies, 1%).