Frank Bengel

Myocardial perfusion scintigraphy in Germany in 2009: utilization and state of the practice

PurposeSince 2006, 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, has been surveying the utilization and technical realization of myocardial perfusion scintigraphy (MPS) in Germany. This paper presents the results of the reporting year 2009.MethodsA total of 291 centres participated in the inquiry, including 179 private practices (PP), 86 hospitals (HO) and 26 university hospitals (UH).ResultsMPS of 98,103 patients were reported. The MPS numbers per million population (pmp) were estimated at 2,360; 76% of the MPS were performed in PP, 17% in HO and 7% in UH. The ratio of MPS to coronary angiography to revascularization was 0.5 to 2.3 to 1. Data from 134 centres which participated in the surveys from 2005 to 2009 showed a decrease in MPS utilization of 2.2%. Nearly half of the MPS were requested by ambulatory care cardiologists. Of all MPS studies, 89% were conducted with 99mTc perfusion tracers. Ergometry was the preferred stress test (69%). Adenosine was used in 16%, adenosine + exercise in 7%, dipyridamole in 3%, dipyridamole + exercise in 5% and dobutamine in <1%. Gated single proton emission computed tomography (SPECT) acquisition was performed in 56% of all rest MPS and in 56% of all stress MPS. Both rest and stress MPS were ECG gated in 41%. Only 33% of the centres always performed a quantification of the perfusion studies, whereas 51% did not apply any quantification; 4% of the MPS studies were corrected for attenuation, and 17 centres used transmission sources of 12 CT-based systems.ConclusionA scan activity of 2,380 MPS pmp is in the upper third of the European range. The ratios to coronary angiography and to revascularization suggest that angiography dominates diagnosis and management of coronary artery disease (CAD). The clinical and technical realizations reveal that the predominant goals of further trainings to optimize MPS are in the field of gated SPECT and quantitative perfusion SPECT.

Positionspapier Nuklearkardiologie – Update 2018 : Aktueller Stand der klinischen Anwendung

Das gemeinsame Positionspapier der Arbeitsgemeinschaft „Kardiovaskulare Nuklearmedizin” der Deutschen Gesellschaft fur Nuklearmedizin (DGN) und der Arbeitsgruppe „Nuklearkardiologische Diagnostik” der Deutschen Gesellschaft fur Kardiologie (DGK) aktualisiert das Positionspapier aus dem Jahr 2009. Es gibt einen Uberblick uber die Einsatzbereiche, den State of the Art und den aktuellen Stellenwert der nuklearkardiologischen Bildgebung. Behandelt werden die Themenfelder der chronischen KHK einschlieslich der Vitalitatsdiagnostik, ferner der Kardiomyopathien, der entzundlichen Endokarditiden, der kardialen Sarkoidose und Amyloidose.The joint position paper of the working community Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN) and the working group Nuclear Cardiology Diagnostics of the German Cardiac Society (DKG) updates the former 2009 paper. It is the purpose of this paper to provide an overview about the application fields, the state-of-the-art and the current value of nuclear cardiology imaging. The topics covered are chronic coronary artery disease, including viability imaging, furthermore cardiomyopathies, infective endocarditis, cardiac sarcoidosis and amyloidosis.