Letter From the Editors

Following its introduction into routine nuclear cardiology in the mid-1970, myocardial perfusion imaging (MPI) witnessed great growth and popularity for 3 decades. Starting with thallium-201 planar imaging and progressing to SPECT imaging with Tc-99m sestamibi, MPI has added a powerful imaging tool for detecting both the presence and extent of coronary artery disease. As our knowledge increased and technologic advances flourished, it became possible to obtain additional information concerning risk assessment and prognosis. From 2000-2006, the use of MPI increased by 41%. However, for a variety of reasons, this trend has reversed with a 51% decline from 2006-2011. Several reasons have been cited to account for this decline. These include increased usage of other imaging examinations such as coronary CT angiography and stress echocardiography. Other factors including incorporation of appropriate use criteria, for example, diminishing referral for cardiac clearance of low-risk patients for noncardiac surgery, such as cataract removal, need for precertification, and a growing concern about patient radiation exposure have clearly played a role, as well. Finally and importantly, cardiologists performing myocardial perfusion studies in their private offices appear to have less incentive because of issues associated with reimbursement.
Source: Seminars in Nuclear Medicine - Category: Radiology Authors: Source Type: research