Future growth and success of nuclear cardiology

Excerpt

About 6 months ago, I reviewed a manuscript, and subsequently wrote an editorial,1 pertaining to a retrospective study undertaken by Mayo Clinic investigators, reporting a marked decline in the annual volume of SPECT myocardial perfusion imaging (MPI) studies in patients with known CAD, from 1425 in 2003, to 552 in 2012.2 This report followed a prior publication from the same group in 2016, indicating that the volume of SPECT MPI in patients without known CAD had decreased from 2490 in 2003 to 1033, in 2012.3 In the more recent report,2 the authors further showed that the percentage of high-risk SPECT results also diminished over time, from 47.8% of all studies in years 1991-1995, to only 8.1% in years 2011-2012. This decrease in high-risk SPECT imaging results occurred, even though the prevalence of CAD risk factors, except for smoking, in the tested population increased over this time period. A similar observation was made by the Cedars Sinai group,4 which reported a progressive decrease in abnormal SPECT MPI studies from 40.9% in 1991 to 8.7% in 2009. The incidence of stress-induced ischemia fell from 29.6% to 5.0% of imaging studies, accompanied by a marked decrease in patients manifesting moderate-to-severe ischemia. …