Myocardial perfusion scintigraphy in Germany

2007 ◽  
Vol 46 (02) ◽  
pp. 49-55 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  

SummaryThe working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: A questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (>75%) was performed with 99mTc-MIBI or tetrofosmin. 201Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: In Germany, MPS is predominantly performed with 99mTc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization.

2010 ◽  
Vol 49 (02) ◽  
pp. 65-72 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  

Summary Aim: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society herewith present the results of the 4th survey on myocardial perfusion scintigraphy (MPS) of the year 2008. Method: 310 questionnaires (191 private practices (PP), 93 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 98 947 patients were reported. 15% of them were younger than 50 y, 57% between 50 and 70 y and 28% older than 70 y. 88% [2007: 83%] of all were studied with Tc-99m perfusion tracers. The patient radiation exposure of a stress and rest protocol considering German standard recommended doses was 8.5 mSv, of a stress-only protocol 1.9 mSv. 77% [2007: 76%] of the MPS were performed in PP, 15% [2007: 15%] in HO and 8% [2007: 9%] in UH. From 2005 to 2008 there was a mild increase in the MPS numbers by 1.2% (PP +7.1%, HO −5.5%, UH −31.4%). The type of stress was pharmacological in 30% [2007: 27%]; 68% adenosine (of these 22% with exercise), 29% dipyridamole (of these 64% with exercise), and <1% dobutamine. Gated SPECT was performed in 46% [2007: 47%] of all rest and in 42% [2007: 44%] of all stress MPS. 62% [2007: 61%] of all institutions did not use perfusion scores. Conclusion: The MPS numbers from 2005 to 2008 in Germany can be regarded as stable. However, there are considerable shifts from HO and UH to PP. The well known potential of MPS considering risk stratification and functional analysis has not been tapped so far. Both gated SPECT and a quantitative perfusion analysis should be performed routinely in every patient.


2009 ◽  
Vol 48 (04) ◽  
pp. 131-137 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  

Summary Aim: This third survey of the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine in cooperation with the working group Nuclear Cardiology of the German Cardiac Society was to deliver information on the procedures and in particular on the development of myocardial perfusion scintigraphy (MPS) from 2005 to 2007. Method: 370 questionnaires (222 private practices (PP), 117 hospitals (HO), 31 university hospitals (UH)) were evaluated. Results: MPS of 114,374 patients were reported, 83% were investigated with 99mTc-perfusion tracers. 76% [2006=74%] were performed in PP, 15% [2006=17%] in HO and 9% [2006=9%] in UH. Diabetics represented 21% of all MPS patients in 2007. Data of 215 institutions which participated all from 2005 to 2007 showed an increase in MPS of 2.3% (PP +6.8%, HO −4.5%, UH −18.2%). The type of stress was pharmacological in 27% [2006 = 27%]; 67% adenosine (of these 25% with exercise), 31% dipyridamole (of these 55% with exercise), and 2% dobutamine. Gated SPECT was performed in 47% [2006 = 42%] of all rest and in 44% [2006 = 39%] of all stress MPS. 61% [2006 = 83%] of all institutions did not apply perfusion scores. 20% [2006 = 24%] of the institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2007 despite competing methods. Gated SPECT has experienced more acceptance, but is still underrepresented. As compared to the European average and general standards of MPS a considerable backlog accounts to pharmacological stress tests, gated SPECT and perfusion scores.


2008 ◽  
Vol 47 (04) ◽  
pp. 139-145 ◽  
Author(s):  
W. Burchert ◽  
F. M. Bengel ◽  
R. Zimmermann ◽  
J. vom Dahl ◽  
W. Schäfer ◽  
...  

SummaryAim: This second survey was to deliver further information on myocardial perfusion scintigraphy (MPS) in Germany in 2006. Method: 351 questionnaires were evaluated: 207 private practices (PP), 117 hospitals (HO), 27 from university hospitals (UH). Results: MPS of 106 331 patients were reported, 85% were investigated with 99mTc-perfusion tracers. 74% [2005=72%] were performed in PP, 17% [2005=15%] in HO and 9% [2005=13%] in UH. PP, which participated in 2005 and 2006, demonstrated an increase by 3,9% (HO 0%, UH –13,0%). The type of stress was pharmacological in 27% [2005=22%]; 54% adenosine (of these 29% with exercise), 37% dipyridamole (of these 56% with exercise), and 9% dobutamine. Gated SPECT was performed in 42% [2005=36%] of all restand in 39% [2005=32%] of all stress MPS. An attenuation correction was used by 69 [2005=78] institutions. 40% of all MPS were performed in patients suspected to have CAD. 24% of all institutions reported changes in the use of MPS by competing methods. Conclusion: There is a small increase of MPS between 2005 and 2006 despite competing methods. Gated SPECT has experienced more acceptance. Suspicion of CAD is an important indication of MPS. In order to tap the full potential of MPS a gated SPECT should be performed routinely.


2014 ◽  
Vol 53 (01) ◽  
pp. 13-18 ◽  
Author(s):  
W. Burchert ◽  
M. Schäfers ◽  
W. Schaefer ◽  
O. Lindner

SummaryAim: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 6th survey on myocardial perfusion scintigraphy (MPS) of the reporting year 2012. Method: 278 questionnaires (177 private practices (PP), 78 hospitals (HO), 23 university hospitals (UH)) were evaluated. Results: MPS of 105,941 patients were reported. 95% [2005 = 80%] of MPS studies were conducted with 99mTc perfusion radiopharmaceuticals and only 5% with 201Tl. 79% [2009 = 76%] of the MPS were performed in PP, 15% [2009 = 17%] in HO, and 6% [2009 = 7%] in UH. Data from 108 centres which participated in all surveys from 2005 to 2012 showed an increase in MPS numbers of 4.0% (PP +6.1%, HO +18.2%, UH –18.3%). 29% of all participants (27% of PP, 31% of HO, and 26% of UH) noticed no change and 26% of all participants (28% of PP, 17% of HO and 35% of UH) an increase in their MPS requests since the 2009 query. The type of stress was pharmacological in 39% [2009 = 31%]. Of these 61% with adenosine (39% with exercise), 22% with regadenoson (51% with exercise), 14% with dipyridamole (60% with exercise), and 3% with dobutamine. Gated SPECT was performed in 73% [2009 = 56%] of all rest, in 70% [2009 = 56%] of all stress and in 67% [47%] of all stress and rest MPS. Only 36% [2009 = 33%] of the centres performed a quantification of all their studies with scores, whereas 41% [2009 = 52%] did not apply any quantification. 60% [2009 = 49%] of the MPS were requested by ambulatory care cardiologists. Conclusion: The survey on MPS in Germany reveals a good conformity of imaging procedures with the current guideline. A positive development in MPS practice and referral can be stated. However, there is still some potential of MPS processing considering the quantitative perfusion analysis.


Author(s):  
Nikant Sabharwal ◽  
Chee Yee Loong ◽  
Andrew Kelion

Planar acquisitions 122General approach to reporting SPECT images 124Review looped cine of raw data projections 126Qualitative and semi-quantitative evaluation of tomographic slices 128Quantitative analysis 132Gated SPECT 134Attenuation correction 136Image artefacts 138Instrumentation-related artefacts 140Processing-related and display-related artefacts ...


2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
B Guzic Salobir ◽  
M Dolenc Novak ◽  
M Stalc

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Department for nuclear medicine in the University medical centre Ljubljana provides nuclear medicine diagnostic procedures for approximately 1.000.000 inhabitants of Slovenia. As many countries in Europe, Slovenia was faced with the first wave of the COVID-19 pandemic in early spring of 2020. Since our country is situated next to the northern part of Italy, where the situation was critical, our Ministry of health issued specific recommendations in March 2020. The aim was to increase hospital capacities for COVID-19 patients through limiting non-urgent diagnostic tests including myocardial perfusion scintigraphy (MPS) and to minimize the spread of the virus into hospital departments. The epidemiologic situation of the first wave resolved within 3 months. In the second wave of the pandemic in autumn 2020, the recommendations on patient care in non COVID-19 cases were less limiting to avoid worsening of non COVID-19 related diseases and patient prognosis. Purpose The aim of our study was to evaluate the influence of the COVID-19 pandemic on MPS in our medical institution. Methods Data on numbers of MPS, clinical characteristics of the patients and findings of MPS were prospectively collected for the first wave (in spring from March 15th to June 15th 2020) and second wave (in autumn from September 15th to December 15th 2020) of the pandemic and were compared with the same periods in 2019.  Results During the first wave we performed 40% less MPS, significantly more patients had pharmacological stress and were outpatients than in spring 2019. There were no significant differences in other clinical characteristics and MPS findings (Table 1 and Figure 1). In autumn 2020 we reorganized our schedule to increase the number of patients, which was once again comparable to previous year’s autumn. Although the number of patients was comparable, patients were now significantly older and had more often pharmacological stress, but there were no significant differences in other clinical data or MPS findings (Table 1 and Figure 1). Conclusions In our hospital, during the first wave of COVID-19 pandemic, we performed significantly less MPS than in the same period of the previous year. To minimize the possibility of virus transmission from asymptomatic patients, we followed international recommendations and avoided exercise stress tests but increased the percentage of pharmacological stress tests. A similar approach regarding the type of stress tests was chosen for the second wave in autumn of 2020. However, we decided to increase the number of MPS performed, in order to lessen the negative impact of the pandemic on non COVID-19 related diseases, focusing on coronary artery disease.


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