Institut Für Radiologie, Nuklearmedizin Und Molekulare Bildgebung, Herz- Und Diabeteszentrum NRW, Bad Oeynhausen, Germany.
Klinik Für Nuklearmedizin, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany.
Eur J Nucl Med Mol Imaging. 2023 May;50(6):1621-1628. doi: 10.1007/s00259-023-06129-z. Epub 2023 Feb 13.
This paper summarises the results of 4 national surveys on the numbers, utilisation and technique of myocardial perfusion SPECT (MPS) from 2012 to 2021.
A one-page questionnaire for information on MPS in 2012, 2015, 2018 and 2021 was sent to German centres practising nuclear medicine. To check for representativeness, the numbers obtained were related to official annual data and furthermore to the numbers of invasive coronary angiography procedures (ICA).
MPS examinations increased by > 40% from 2012 to 2021 and showed a centralisation with increasing MPS per centre. In 2020, a mild impact of the COVID-19 pandemic could be observed in the form of only a slight MPS increase, which was compensated in the following year. Outpatient care cardiologists represent the most important referrer (70%). Mostly, 2-day protocols were used. One-day protocols and stress-only protocols showed insignificant changes. The use of exercise stress decreased steadily. In 2021, exercise stress was replaced by pharmacological stress as the most frequent stress modality. Camera systems showed a shift to more SPECT-CT systems. The use of gated SPECT increased to almost 90%. Quantitative scoring showed an increasing acceptance. The ratio of invasive coronary angiographies (ICA) to MPS was between 3.9 and 4.5. A significant proportion of ICA in the context of CCS (chronic coronary syndrome) was performed without prior testing for ischaemia.
The 2012 to 2021 MPS surveys reveal a continuously growing number of examinations with only a mild temporary effect of the COVID-19 pandemic and a centralisation with increasing numbers per centre. Performance and technical data reveal a high-grade adherence of MPS practice to the current ESC guideline. A large potential of non-invasive diagnostics remains for the future.
本文总结了 2012 年至 2021 年 4 项关于心肌灌注 SPECT（MPS）数量、应用和技术的全国性调查结果。
向德国核医学实践中心发送了一份关于 2012 年、2015 年、2018 年和 2021 年 MPS 的一页问卷，以获取信息。为了检查代表性，将获得的数字与官方年度数据以及侵入性冠状动脉造影程序（ICA）的数量进行了比较。
MPS 检查从 2012 年到 2021 年增加了超过 40%，并显示出随着中心数量的增加而集中的趋势。2020 年，COVID-19 大流行的轻微影响表现为 MPS 仅略有增加，这在次年得到了补偿。门诊心脏病专家是最重要的转诊医生（70%）。大多采用 2 天方案。1 天方案和仅应激方案没有明显变化。运动应激的使用稳步下降。2021 年，药物应激取代运动应激成为最常见的应激方式。相机系统向更多的 SPECT-CT 系统转移。门控 SPECT 的使用增加到近 90%。定量评分的接受度不断提高。ICA 与 MPS 的比例在 3.9 到 4.5 之间。CCS（慢性冠状动脉综合征）背景下进行的 ICA 中有很大一部分是在没有进行缺血检测的情况下进行的。
2012 年至 2021 年 MPS 调查显示，检查数量持续增长，仅受到 COVID-19 大流行的轻微暂时影响，并且随着中心数量的增加而集中。表现和技术数据显示，MPS 实践高度符合当前 ESC 指南。未来仍有很大的非侵入性诊断潜力。
