Abstracts/ProceedingsAssessing the need for nuclear cardiology and other advanced cardiac imaging modalities in the developing world
Section snippets
The Growing Denominator of High-Risk Patients in Developing Countries
Prior to our examination of current utilization patterns for nuclear cardiology, it is helpful to review whether the population needs are sufficiently high in order that patients may benefit from costly, advanced imaging techniques, such as nuclear cardiology. Throughout the developing world, expanding urbanization and industrialization promote lifestyle changes which accelerate CVD risk. What has been observed in many developing countries is rapid population shifts and epidemic growth rates in
Worldwide Utilization of Nuclear Cardiology
In 2008, a world-wide survey was carried out as to the annual utilization of nuclear cardiology. Sources for this information included data provided by countries and regional scientific societies and working groups, as well as leaders in the field within their respective countries. For utilization calculations, we used the number of annual procedures (i.e., largely myocardial perfusion studies) within a given country divided by the current population statistics (2007 data); expressed per
Contrasting Developed and Developing Countries Utilization of Nuclear Cardiology Services
In the United States as well as in many developed countries, there has been substantial growth in nuclear cardiology services. Growth in imaging has occurred at such a rapid pace that in 2007 Medicare allowable charges were 1.1 billion US dollars for stress myocardial perfusion SPECT including recent utilization statistics of 8.54 million studies.9 This tremendous growth in all imaging sectors has led to demands for more evidence to differentiate appropriate from inappropriate testing.10 Thus,
Growth in Contemporary Diagnostic Tests for CVD
There is an array of diagnostic tests for CVD and nuclear cardiology, notably stress myocardial perfusion SPECT, constitutes one method that may provide a means to improve risk detection in developing countries. One reason for the current report is that many developing countries have existing nuclear cardiology networks with numerous examples of acceptance of this modality. Moreover, the current focus on nuclear cardiology within the International Atomic Energy Agency coincides with numerous
Training in Nuclear Cardiology
While in developed countries the practice of nuclear cardiology is well regulated, this is not the case within the majority of developing countries. The training and practice of nuclear cardiology poses unique challenges, as in most countries, it is a joint effort between radiology, nuclear medicine, and cardiology. As stated in a statement from the European Society of Cardiology (ESC), these three specialties should work collaboratively to foster high-quality nuclear cardiology studies.11
Conclusions
Worldwide urbanization is causing rapid population shifts in CVD risk including near epidemic growth in obesity and diabetes. The vast majority of deaths related to CVD occur in low- to middle-income countries where advanced cardiac imaging technology is less often available. Utilization of nuclear cardiology worldwide generally mirrors a countries’ gross domestic product. The development of programs aimed at creating centralized centers for training, education, research, and service may
Acknowledgments
In addition to data provided by IAEA member states and members of the technical panel, we would like to thank the following physicians for contributing data to this report (in alphabetical order of countries): (1) Argentina: Angel Sandrin; (2) Bangladesh: Luftun Nisa; (3) Bolivia: Raul Araujo; (4) Colombia: Sonia Merlano; (5) Costa Rica: Ulises Gonzalez; (6) Ecuador: Sandra Moreno; (7) Europe and Russian Federation: Ignasio Carrio, Richard Underwood; (8) Israel: Chaim Golan, Arie Wolak; (9)
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See related editorial, doi:10.1007/s12350-009-9122-9.