Abstract
BackgroundIn myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. If the stress study is considered normal, there is no need for a subsequent rest study. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study.MethodsGated MPS using a 2-day 99mTc protocol for 121 consecutive patients were studied. Visual interpretation by 3 physicians was used as gold standard for determining the need for a rest study based on the stress images. All nuclear medicine technologists performing MPS had to review 82 training cases of stress MPS images with comments regarding the need for rest studies, and thereafter a test consisting of 20 stress MPS images. After passing this test, the nuclear medicine technologists in charge of a stress MPS study assessed whether a rest study was needed or not or if he/she was uncertain and wanted to consult a physician. After that, the physician in charge interpreted the images and decided whether a rest study was required or not.ResultsThe nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study. In the remaining 14 cases the technologists were uncertain, i.e. wanted to consult a physician. The agreement between the technologists and the physicians in clinical routine was very good, resulting in a kappa value of 0.92. There was no statistically significant difference in the evaluations made by technicians and physicians (P = 0.617).ConclusionsThe nuclear medicine technologists were able to accurately determine whether a rest study was necessary. There was very good agreement between nuclear medicine technologists and physicians in the assessment of the need for a rest study. If the technologists can make this decision, the effectiveness of the nuclear medicine department will improve.
Highlights
In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed
This includes that in order to be considered as “completely normal” or “probably normal” study, the perfusion intensity had to be so high in the stress image of either the non-attenuation corrected (NC) or the AC images, that no matter the appearance of the rest study, the study would still not be considered as having a defect
Comparison between physicians and nuclear medicine technologists The nuclear medicine technologists and the physicians in clinical routine agreed in 103 of the 107 cases (96%) for which the technologists felt certain regarding the need for a rest study
Summary
In myocardial perfusion scintigraphy (MPS), typically a stress and a rest study is performed. The aim of the study was to determine whether nuclear medicine technologists are able to assess the necessity of a rest study. Chang et al [7] investigated whether a normal stressonly MPS confers the same prognosis as a normal MPS on the bases of evaluation of stress and rest images. The assessment of whether a rest study is needed is usually made by a physician. If this could be delegated to the technologist who acquires the stress images, clinic workflow could improve. The aim of the present study was to determine whether nuclear medicine technologists are able to determine the need for a rest study
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