Division of Medical Technology and Science, Department of Medical Physics and Engineering, Course of Health Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
J Nucl Cardiol. 2017 Dec;24(6):1850-1855. doi: 10.1007/s12350-017-0867-2. Epub 2017 Mar 28.
Ionizing radiation generated during medical imaging procedures is a matter of concern. However, the current status of radiopharmaceutical use in stress myocardial perfusion imaging (MPI) and the radiation exposure from these radiopharmaceuticals is unknown in Japan.
A nationwide survey was conducted from June through July 2016. The questionnaires on the radiopharmaceuticals used and their administered doses during stress MPI were sent to 641 nuclear medicine facilities. The responses were collected from 431 facilities and the effective dose (ED) for an adult with standard body weight was calculated. Forty-three percent of the facilities used only TlCl, 35% used only Tc radiopharmaceuticals, and the remaining 22% used both. The two main reasons for using TlCl instead of Tc radiopharmaceuticals were "more familiarity with the usage of TlCl than Tc radiopharmaceuticals" and "apprehension about increasing the burden of physicians performing tracer injection twice." The mean ED was 14.0 ± 5.5 mSv (range, 3.9 to 25.2 mSv), which was higher than that reported in other countries.
The ED of stress MPI radiopharmaceuticals in Japan is probably higher than the world standard because more than 50% of the facilities still use TlCl. We recommend revising the routine stress MPI protocol to reduce the effects of ionizing radiation.
医学影像检查过程中产生的电离辐射令人担忧。然而，目前在日本，人们对于放射性药物在应激心肌灌注成像（MPI）中的使用情况以及这些放射性药物的辐射暴露情况并不了解。
本研究于 2016 年 6 月至 7 月期间开展了一项全国性调查。向 641 家核医学设施发放了关于应激 MPI 中使用的放射性药物及其给药剂量的调查问卷，并从 431 家设施中收集了回复，计算了标准体重成人的有效剂量（ED）。43%的设施仅使用 TlCl，35%的设施仅使用 Tc 放射性药物，其余 22%的设施同时使用这两种药物。选择 TlCl 而非 Tc 放射性药物的两个主要原因是“对 TlCl 的使用比 Tc 放射性药物更熟悉”和“担心增加医生进行两次示踪剂注射的负担”。平均 ED 为 14.0±5.5mSv（范围为 3.9 至 25.2mSv），高于其他国家的报告值。
由于超过 50%的设施仍在使用 TlCl，日本应激 MPI 放射性药物的 ED 可能高于世界标准。我们建议修订常规应激 MPI 方案以减少电离辐射的影响。
