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Research Letter
February 2016

Estimating the Reduction in the Radiation Burden From Nuclear Cardiology Through Use of Stress-Only Imaging in the United States and Worldwide

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York–Presbyterian Hospital, New York
  • 2Section of Nuclear Medicine and Diagnostic Imaging, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
  • 3Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
  • 4Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
  • 5Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
  • 6Department of Radiology, Columbia University Medical Center, New York–Presbyterian Hospital, New York
JAMA Intern Med. 2016;176(2):269-273. doi:10.1001/jamainternmed.2015.7106

Myocardial perfusion imaging (MPI) is invaluable in diagnosing and managing coronary artery disease; however, it accounts for approximately 10% of the radiation burden to the US population.1 Use of a “stress-only” imaging protocol, whereby stress imaging is performed first and subsequent rest imaging is omitted when stress images are determined to be normal, has been shown to reduce radiation burden without compromising patient safety.2 Although single-center data support that a 60% reduction in radiation dose may be realized with the use of stress-only imaging,2 data from a US survey suggest that stress-only protocols are infrequently performed.3 We sought to estimate current rates of stress-only imaging in the United States and worldwide, as well as the potential effect of changes in this rate on the radiation burden to the US population.

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