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CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(03): 281-285
DOI: 10.4103/wjnm.WJNM_77_20
Original Article

Appropriate use criteria in myocardial perfusion imaging in a tertiary care hospital in South India: An audit

Madhur Kumar Srivastava
0   Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
,
Ram Manohar Pagala
0   Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
,
Vinodh Kendarla
0   Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
,
Kavitha Nallapareddy
0   Department of Nuclear Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India
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Abstract

Myocardial perfusion imaging (MPI) is an important investigative tool in the diagnosis and management of coronary artery disease. This investigation has seen a manifold increase in number in past decades as compared to other investigations such as cardiac magnetic resonance imaging/positron emission tomography or computed tomography. In 2005, “Appropriate use criteria (AUC) in cardiac radionuclide imaging” was formulated by the American College of Cardiology Foundation and the American Society of Nuclear Cardiology for effective use of this investigation, later revised in 2009. We assessed the appropriateness of indications for MPI in patients presenting to the nuclear medicine department of a tertiary care hospital according to the latest AUC for cardiac radionuclide imaging. This is a retrospective analysis of all cardiac perfusion scans performed from June 2019 to January 2020 in a tertiary care teaching hospital in South India. All patients' indications for MPI were assessed for appropriateness using AUC 2009 as appropriate, inappropriate, and uncertain indications by two experienced nuclear medicine physicians blinded for results of the test and hospital stay of the patients. A total of 1015 cardiac scans were performed in the given period, which were analyzed. This included 613 males and 402 females, with most of the patients aged above 60 years (n = 640; males = 385, females = 255). Most of the patients had diabetes mellitus or hypertension or both except in 161 patients (15.8%) which did not have either of the comorbidities. Chest pain and/or shortness of breath were the most common presenting complaints. The appropriate indication for imaging was found in 784 patients (77.2%), inappropriate in 121 patients (12%), and uncertain in 110 patients (10.8%). Our results showed appropriate indication to be 77.2% and inappropriate indications as 12% for MPI referrals in a tertiary care teaching hospital, similar to Western literature but can be improved further by continued teaching and awareness campaigns.

Keywords

Appropriate use criteria - Choosing Wisely® campaign - inappropriate indication - myocardial perfusion imaging - uncertain indication

Financial support and sponsorship

Nil.




Publication History

Received: 05 June 2020

Accepted: 18 July 2020

Article published online:
24 March 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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