Reduction in occupational and patient radiation exposure from myocardial perfusion imaging

Impact of stress-only imaging and high-efficiency SPECT camera technology

W. Lane Duvall, Krista A. Guma, Jacob Kamen, Lori B. Croft, Michael K. Parides, Titus George, Milena J. Henzlova

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Recently introduced high-efficiency SPECT cameras have demonstrated the ability to reduce radiation exposure to patients undergoing myocardial perfusion imaging studies, especially when combined with stress-only imaging protocols. To date there have been no relevant studies examining the reduced occupational radiation exposure to medical staff. We sought to determine whether changes in stress myocardial perfusion imaging protocols and camera technology can reduce the occupational radiation exposure to the staff of a nuclear cardiology laboratory. Methods: Monthly radiation dosimeter readings from 4 nuclear technologists, 4 nurses, and 2 administrative employees were analyzed from two 12-mo periods: October 2007-September 2008 (period 1), before the use of high-efficiency SPECT, and October 2010-September 2011 (period 2), after high-efficiency SPECT was introduced. The average monthly dose equivalent in millirems (1 mrem 5 0.01 mSv) was recorded from personal dosimeters worn on laboratory coats. The total activity of 99mTc used per month, mean 99mTc administered activity per patient, average number of patients per month, patient time spent in the laboratory, and proportion of stress-only studies were determined. Results: There were 3,539 patients in period 1 and 3,898 in period 2. An approximately 40% reduction in the dose equivalent across all staff members occurred during this time (216.9 and 216.2 mrem for nuclear technologists and nurses, respectively; P < 0.0001). During period 2, the total activity of 99mTc used per month decreased (10,746 vs. 7,174 mCi [1 mCi 5 37 MBq], P < 0.0001), as did the mean 99mTc administered activity per patient (36.5 vs. 23.8 mCi, P < 0.0001). The percentage of patients having stress-only imaging increased (35% vs. 56%, P < 0.0001), and the total patient time spent in the laboratory decreased. Radiation dose equivalent levels were reduced in period 2 to 1%-7% of the allowed annual occupational dose equivalent. The combination of the use of high-efficiency SPECT technology and stress-only protocols resulted in a 34.7% reduction in mean total 99mTc administered activity between time periods, with camera technology being responsible for 39.2% of the reduction and stress-only protocols for 60.8%. Conclusion: A combination of high-efficiency SPECT technology and selective use of stress-only protocols significantly reduces the occupational radiation dose equivalent to the staff of a nuclear cardiology laboratory. COPYRIGHT

Original languageEnglish (US)
Pages (from-to)1251-1257
Number of pages7
JournalJournal of Nuclear Medicine
Volume54
Issue number8
DOIs
StatePublished - Aug 1 2013
Externally publishedYes

Fingerprint

Myocardial Perfusion Imaging
Single-Photon Emission-Computed Tomography
Technology
Occupational Exposure
Cardiology
Nurses
Radiation
Radiation Exposure
Medical Staff
Reading

Keywords

  • High-efficiency SPECT
  • Myocardial perfusion imaging
  • Radiation exposure
  • Stress-only imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Reduction in occupational and patient radiation exposure from myocardial perfusion imaging : Impact of stress-only imaging and high-efficiency SPECT camera technology. / Duvall, W. Lane; Guma, Krista A.; Kamen, Jacob; Croft, Lori B.; Parides, Michael K.; George, Titus; Henzlova, Milena J.

In: Journal of Nuclear Medicine, Vol. 54, No. 8, 01.08.2013, p. 1251-1257.

Research output: Contribution to journalArticle

Duvall, W. Lane ; Guma, Krista A. ; Kamen, Jacob ; Croft, Lori B. ; Parides, Michael K. ; George, Titus ; Henzlova, Milena J. / Reduction in occupational and patient radiation exposure from myocardial perfusion imaging : Impact of stress-only imaging and high-efficiency SPECT camera technology. In: Journal of Nuclear Medicine. 2013 ; Vol. 54, No. 8. pp. 1251-1257.
@article{a53e6007ad4a4ec6ab3222fefa111a79,
title = "Reduction in occupational and patient radiation exposure from myocardial perfusion imaging: Impact of stress-only imaging and high-efficiency SPECT camera technology",
abstract = "Recently introduced high-efficiency SPECT cameras have demonstrated the ability to reduce radiation exposure to patients undergoing myocardial perfusion imaging studies, especially when combined with stress-only imaging protocols. To date there have been no relevant studies examining the reduced occupational radiation exposure to medical staff. We sought to determine whether changes in stress myocardial perfusion imaging protocols and camera technology can reduce the occupational radiation exposure to the staff of a nuclear cardiology laboratory. Methods: Monthly radiation dosimeter readings from 4 nuclear technologists, 4 nurses, and 2 administrative employees were analyzed from two 12-mo periods: October 2007-September 2008 (period 1), before the use of high-efficiency SPECT, and October 2010-September 2011 (period 2), after high-efficiency SPECT was introduced. The average monthly dose equivalent in millirems (1 mrem 5 0.01 mSv) was recorded from personal dosimeters worn on laboratory coats. The total activity of 99mTc used per month, mean 99mTc administered activity per patient, average number of patients per month, patient time spent in the laboratory, and proportion of stress-only studies were determined. Results: There were 3,539 patients in period 1 and 3,898 in period 2. An approximately 40{\%} reduction in the dose equivalent across all staff members occurred during this time (216.9 and 216.2 mrem for nuclear technologists and nurses, respectively; P < 0.0001). During period 2, the total activity of 99mTc used per month decreased (10,746 vs. 7,174 mCi [1 mCi 5 37 MBq], P < 0.0001), as did the mean 99mTc administered activity per patient (36.5 vs. 23.8 mCi, P < 0.0001). The percentage of patients having stress-only imaging increased (35{\%} vs. 56{\%}, P < 0.0001), and the total patient time spent in the laboratory decreased. Radiation dose equivalent levels were reduced in period 2 to 1{\%}-7{\%} of the allowed annual occupational dose equivalent. The combination of the use of high-efficiency SPECT technology and stress-only protocols resulted in a 34.7{\%} reduction in mean total 99mTc administered activity between time periods, with camera technology being responsible for 39.2{\%} of the reduction and stress-only protocols for 60.8{\%}. Conclusion: A combination of high-efficiency SPECT technology and selective use of stress-only protocols significantly reduces the occupational radiation dose equivalent to the staff of a nuclear cardiology laboratory. COPYRIGHT",
keywords = "High-efficiency SPECT, Myocardial perfusion imaging, Radiation exposure, Stress-only imaging",
author = "Duvall, {W. Lane} and Guma, {Krista A.} and Jacob Kamen and Croft, {Lori B.} and Parides, {Michael K.} and Titus George and Henzlova, {Milena J.}",
year = "2013",
month = "8",
day = "1",
doi = "10.2967/jnumed.112.112680",
language = "English (US)",
volume = "54",
pages = "1251--1257",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "8",

}

TY - JOUR

T1 - Reduction in occupational and patient radiation exposure from myocardial perfusion imaging

T2 - Impact of stress-only imaging and high-efficiency SPECT camera technology

AU - Duvall, W. Lane

AU - Guma, Krista A.

AU - Kamen, Jacob

AU - Croft, Lori B.

AU - Parides, Michael K.

AU - George, Titus

AU - Henzlova, Milena J.

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Recently introduced high-efficiency SPECT cameras have demonstrated the ability to reduce radiation exposure to patients undergoing myocardial perfusion imaging studies, especially when combined with stress-only imaging protocols. To date there have been no relevant studies examining the reduced occupational radiation exposure to medical staff. We sought to determine whether changes in stress myocardial perfusion imaging protocols and camera technology can reduce the occupational radiation exposure to the staff of a nuclear cardiology laboratory. Methods: Monthly radiation dosimeter readings from 4 nuclear technologists, 4 nurses, and 2 administrative employees were analyzed from two 12-mo periods: October 2007-September 2008 (period 1), before the use of high-efficiency SPECT, and October 2010-September 2011 (period 2), after high-efficiency SPECT was introduced. The average monthly dose equivalent in millirems (1 mrem 5 0.01 mSv) was recorded from personal dosimeters worn on laboratory coats. The total activity of 99mTc used per month, mean 99mTc administered activity per patient, average number of patients per month, patient time spent in the laboratory, and proportion of stress-only studies were determined. Results: There were 3,539 patients in period 1 and 3,898 in period 2. An approximately 40% reduction in the dose equivalent across all staff members occurred during this time (216.9 and 216.2 mrem for nuclear technologists and nurses, respectively; P < 0.0001). During period 2, the total activity of 99mTc used per month decreased (10,746 vs. 7,174 mCi [1 mCi 5 37 MBq], P < 0.0001), as did the mean 99mTc administered activity per patient (36.5 vs. 23.8 mCi, P < 0.0001). The percentage of patients having stress-only imaging increased (35% vs. 56%, P < 0.0001), and the total patient time spent in the laboratory decreased. Radiation dose equivalent levels were reduced in period 2 to 1%-7% of the allowed annual occupational dose equivalent. The combination of the use of high-efficiency SPECT technology and stress-only protocols resulted in a 34.7% reduction in mean total 99mTc administered activity between time periods, with camera technology being responsible for 39.2% of the reduction and stress-only protocols for 60.8%. Conclusion: A combination of high-efficiency SPECT technology and selective use of stress-only protocols significantly reduces the occupational radiation dose equivalent to the staff of a nuclear cardiology laboratory. COPYRIGHT

AB - Recently introduced high-efficiency SPECT cameras have demonstrated the ability to reduce radiation exposure to patients undergoing myocardial perfusion imaging studies, especially when combined with stress-only imaging protocols. To date there have been no relevant studies examining the reduced occupational radiation exposure to medical staff. We sought to determine whether changes in stress myocardial perfusion imaging protocols and camera technology can reduce the occupational radiation exposure to the staff of a nuclear cardiology laboratory. Methods: Monthly radiation dosimeter readings from 4 nuclear technologists, 4 nurses, and 2 administrative employees were analyzed from two 12-mo periods: October 2007-September 2008 (period 1), before the use of high-efficiency SPECT, and October 2010-September 2011 (period 2), after high-efficiency SPECT was introduced. The average monthly dose equivalent in millirems (1 mrem 5 0.01 mSv) was recorded from personal dosimeters worn on laboratory coats. The total activity of 99mTc used per month, mean 99mTc administered activity per patient, average number of patients per month, patient time spent in the laboratory, and proportion of stress-only studies were determined. Results: There were 3,539 patients in period 1 and 3,898 in period 2. An approximately 40% reduction in the dose equivalent across all staff members occurred during this time (216.9 and 216.2 mrem for nuclear technologists and nurses, respectively; P < 0.0001). During period 2, the total activity of 99mTc used per month decreased (10,746 vs. 7,174 mCi [1 mCi 5 37 MBq], P < 0.0001), as did the mean 99mTc administered activity per patient (36.5 vs. 23.8 mCi, P < 0.0001). The percentage of patients having stress-only imaging increased (35% vs. 56%, P < 0.0001), and the total patient time spent in the laboratory decreased. Radiation dose equivalent levels were reduced in period 2 to 1%-7% of the allowed annual occupational dose equivalent. The combination of the use of high-efficiency SPECT technology and stress-only protocols resulted in a 34.7% reduction in mean total 99mTc administered activity between time periods, with camera technology being responsible for 39.2% of the reduction and stress-only protocols for 60.8%. Conclusion: A combination of high-efficiency SPECT technology and selective use of stress-only protocols significantly reduces the occupational radiation dose equivalent to the staff of a nuclear cardiology laboratory. COPYRIGHT

KW - High-efficiency SPECT

KW - Myocardial perfusion imaging

KW - Radiation exposure

KW - Stress-only imaging

UR - http://www.scopus.com/inward/record.url?scp=84881417729&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881417729&partnerID=8YFLogxK

U2 - 10.2967/jnumed.112.112680

DO - 10.2967/jnumed.112.112680

M3 - Article

VL - 54

SP - 1251

EP - 1257

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 8

ER -