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How to reduce your dose with SPECT MPI studies

Posted on: 10.05.17

Advancements in medical imaging technology have revolutionized health care, allowing doctors to more accurately diagnose disease using SPECT for MPI scans. Any time a physician orders an imaging scan, however, there is always concern about the level of radiation exposure.

ASNC and SNMMI are raising the bar with their guidelines, and the industry as a whole is moving toward a low dose standard. What does that mean and how will that change impact your practice? Here are some resources that will help you better understand and adopt a low dose protocol.

Implementing a low-dose protocol (link)

If you are considering the implementation of a low-dose protocol, you’ll need to evaluate three important elements within your practice: proper patient segmentation, commitment, and technology.

Patient Segmentation

Proper patient segmentation is a large part of implementing a low-dose protocol because each patient is a unique combination of age, weight, shape and medical history. Did you know that ASNC estimates half of the patient population falls under the appropriate criteria for low-dose? Following the ASNC guidelines can help physicians decide when to reduce radiation exposure in order to optimize patient care.

Commitment

It only takes one physician to publicly advocate low-dose imaging to get the conversation started. With this progressive thinking, however, your practice will have to collectively adopt a new low-dose culture. The physicians, both referring and reading, must be committed to a low-dose protocol in order to successfully implement the change. It will require further education, training, leadership, discipline and diligence along with a “can-do” attitude from all parties.

Technology

With a low-dose protocol, the goal is to acquire an image with sufficient quality for maintaining diagnostic accuracy. Maintaining image quality while reducing the patient dose is a challenge, but new technology makes it possible. A multi-head camera, combined with nSPEED reconstruction software and Tru-ACQ Count Based Imaging provides fast acquisition times with the lowest appropriate dose.

TruACQ Count Based Imaging™ is the first and only count-based SPECT imaging technique that ensures consistent counts for every patient study, regardless of the patient’s size, weight, or the dose used. The proprietary software is designed to simplify the decision-making process around acquisition time. TruACQ™ takes a quick look at exactly what the detectors are picking up, which accounts for all possible variables, and provides the optimal scan time for the patient being

Stress-Only Protocol (link)

Another way to help lower the radiation burden to patients is to adopt a stress-only protocol. Stress-only protocol is the directive by which a medical provider performs a cardiac stress test without the complementary resting scan. Traditionally, both a resting scan and a stress scan are performed on patients, which are then compared to more confidently support a diagnosis. Often, what could potentially be an abnormality in one image is disproved by the other, thereby reducing inaccurate conclusions. It does, however, subject the patient to two radiation doses, sometimes unnecessarily.

Those with a low probability of heart disease, typically younger patients who have limited risk factors, are the ideal candidates to forgo the resting scan and follow the stress-only protocol. Not only does the protocol support the global drive to decrease the radiation burden to patients, it also reduces costs, and saves time.

Easing concerns (link)

The word radiation may stir-up heightened concerns, especially if a patient is having multiple tests performed. How much radiation is considered safe and over what time period? Do some tests bring greater exposure than others? At what point should they become concerned? These are all valid questions. The bottom line is that medical imaging is a safe, painless, and cost-effective way to diagnose and treat disease.

Is there a real risk?

Any medical procedure can have side effects, but when the procedure offers useful clinical information that will help your physician decide on your treatment, the benefits of the procedure far outweigh its very small potential risk.

The decision to implement a low-dose protocol is an important step for both you and your patients. Keep in mind that not every patient is required to be low-dose for your practice to be considered a low-dose lab. In the end, it’s about lowering the radiation burden to your patients more than you are now.



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