The American Society of Nuclear Cardiology (ASNC) has outlined new recommendations that could significantly lower radiation exposure for patients undergoing myocardial perfusion imaging (MPI) procedures and have published the recommendations online on May 26 in the Journal of Nuclear Cardiology.

Focused on three areas—patient selection, test selection and technology adoption—ASNC's information statement summarizes best practices for minimizing radiation exposure without sacrificing quality or clinical benefit to the patient.

Employing resources and techniques such as appropriate use criteria, stress-only protocols and iterative reconstruction can significantly contribute to lower radiation doses and higher image quality, according to the authors.  

Lead author Manuel D. Cerqueira, MD, chairman of nuclear medicine at the Imaging Institute and nuclear cardiologist at the Heart and Vascular Institute at the Cleveland Clinic, Ohio and his colleagues who authored the recommendations for reducing radiation exposure with MPI have asked physicians to consider three important questions when ordering and performing MPI tests:

• Is MPI testing appropriate and necessary in this patient?

• How can the MPI protocol be optimized to give the lowest radiation dose while maintaining diagnostic accuracy?
• How can new technologies be utilized to provide the lowest possible radiation dose while maintaining diagnostic accuracy?

Cerqueira and colleagues concluded that if these recommendations are implemented by the nuclear cardiology community, then radiation exposure to patients undergoing MPI tests could be reduced to an average of less than or equal to 9 mSv in 50 percent of studies by 2014.  

"Radiation exposure reduction is a global priority and is achievable today in daily practice without sacrifice of image quality," said ASNC President Mylan Cohen, MD.  "ASNC and the professionals we represent must embrace, endorse, and advance methods to reduce radiation exposure related to cardiac imaging."