Table 3.

Strategies for reducing radiation exposure in women undergoing radionuclide myocardial perfusion imaging

1. Use AUC to guide patient selection for nuclear cardiology procedures.

2. Use technetium-based tracers for SPECT MPI studies. Avoid use of thallium-based and dual-isotope SPECT protocols.

3. Consider stress-first MPI (especially with attenuation correction techniques) for select patients without evidence of prior MI or cardiomyopathy.

4. Implement iterative reconstruction algorithms for use with existing SPECT technology.

5. Use high-sensitivity solid-state CZT SPECT cameras and/or PET MPI where available.

6. Continually review nuclear laboratory practices to implement dose-reduction strategies to decrease patient radiation doses to levels that are as low as reasonably achievable (ALARA) and approaching levels of natural background radiation (3 mSV/year) whenever possible.

AUC, appropriate use criteria; SPECT, single-photon emission computed tomography; MPI, myocardial perfusion imaging; MI, myocardial infarction; CZT, cadmium zinc telluride; PET, positron emission tomography; ALARA, as low as reasonably achievable