Myocardial perfusion scintigraphy in Europe 2007: a survey of the European Council of Nuclear Cardiology

Abstract

Purpose

This is the second of a series of surveys designed to assess myocardial perfusion scintigraphy (MPS) practice in Europe.

Methods

Data were collected from 258 centres in 18 countries. The number of MPS studies per million population (pmp) was estimated assuming that the nonresponding centres performed either no studies (lower estimate) or the same number as the responding centres (upper estimate).

Results

The responding centres served 24% of the population of their countries. The total number of noncardiac nuclear medicine studies was between 2,160 and 8,000 studies pmp. The total number of MPS studies was between 529 and 2,293 pmp. The median number of MPS studies per centre was 571 per year with 57% performing fewer than 500 studies per year and 23% of centres performing fewer than 250 studies per year. There was significant variation between countries, with higher numbers of MPS studies (lower limit of estimate above the mid-range of all countries combined) in Austria, Denmark, Hungary, Portugal and Slovenia, and lower numbers (upper limit of estimate below the mid-range of all countries) in Finland, Norway, Spain and Switzerland. The ratio of MPS to coronary angiography to revascularization procedures was 0.9 to 2.2 to 1. Pharmacological stress was used in 57% and technetium-99m-labelled tracers in 88% of studies. ECG gating was performed in 74% of studies and attenuation correction in 22%.

Conclusion

MPS utilization in Europe remains low compared with coronary angiography although there has been a 21% increase in the number of studies pmp in centres that reported in both 2005 and 2007. Pharmacological agents continue to be the predominant form of stress. Despite the widespread use of technetium-99m-labelled tracers, ECG gating is not universally performed. As in the 2005 survey, imaging aids such as attenuation and motion correction and prone imaging are not commonly used.