The Japanese Circulation Society (JCS) 2021 guideline on radiation safety in cardiology was updated based on the eight best practices for myocardial perfusion single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), which was determined by panels of international atomic energy agency (IAEA) nuclear cardiology protocols cross-sectional study (INCAPS). Although the guideline recommends to avoid too much 201Tl or 201Tl/99mTc dual-isotope protocol, the utilization rate of 201Tl for SPECT-MPI in Japan is considerably high compared to other countries. In Japan, protocols using 99mTc should be appropriately promoted based on the guideline to reduce radiation exposure in SPECT-MPI. Among the eight practices, stress-only imaging is considered to be a useful strategy that contributes to a significant reduction in radiation exposure, and hybrid assessment in combination with rest computed tomography (CT)-MPI is one of the practical application methods.
Keywords: Computed tomography; Hybrid assessment; Myocardial perfusion imaging; Radiation exposure; Single-photon emission computed tomography; Stress-only imaging.
2022, Japanese Society of Nuclear Cardiology.