Recommendations to Decrease/Limit Patient Radiation Exposure in Myocardial Perfusion and Cardiac FDG PET

 

• Follow the recommendation of the American Society of Nuclear Cardiology to decrease patient radiation exposure to < 9 mSv in 50% of patients by 2014⁶
• Follow appropriate use guidelines in selecting patients for myocardial perfusion PET^1,7
  • Do not perform cardiac imaging in patients without cardiac symptoms unless high-risk markers for coronary events are present
  • Do not perform cardiac imaging for patients who are at low risk of coronary events
  • Do not perform radionuclide cardiac imaging as part of routine follow-up of asymptomatic patients
  • Do not perform cardiac imaging as a pre-operative assessment in patients scheduled to undergo low or intermediate risk non-cardiac surgery
• Use 3D imaging mode and lower amounts of radiotracers whenever feasible to reduce radiation dose to the patient¹
• Use a single localizing scan and a single transmission scan if the patient is not moved between the rest and stress scans, whenever feasible, especially for Rubidium-82 imaging
• Minimize tube current for CT based transmission imaging
• When using gated CT imaging for calcium score, use prospective gating methods to reduce radiation dose
• Use combined perfusion imaging and CT coronary angiogram only when the second test is indicated, after review of the results of the first test