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Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry.

Publication ,  Journal Article
Shi, L; Dorbala, S; Paez, D; Shaw, LJ; Zukotynski, KA; Pascual, TNB; Karthikeyan, G; Vitola, JV; Better, N; Bokhari, N; Rehani, MM; Kashyap, R ...
Published in: JACC Cardiovasc Imaging
April 2016

OBJECTIVES: The aim of this study was to investigate gender-based differences in nuclear cardiology practice globally, with a particular focus on laboratory volume, radiation dose, protocols, and best practices. BACKGROUND: It is unclear whether gender-based differences exist in radiation exposure for nuclear cardiology procedures. METHODS: In a large, multicenter, observational, cross-sectional study encompassing 7,911 patients in 65 countries, radiation effective dose was estimated for each examination. Patient-level best practices relating to radiation exposure were compared between genders. Analysis of covariance was used to determine any difference in radiation exposure according to gender, region, and the interaction between gender and region. Linear, logistic, and hierarchical regression models were developed to evaluate gender-based differences in radiation exposure and laboratory adherence to best practices. The study also included the United Nations Gender Inequality Index and Human Development Index as covariates in multivariable models. RESULTS: The proportion of myocardial perfusion imaging studies performed in women varied among countries; however, there was no significant correlation with the Gender Inequality Index. Globally, mean effective dose for nuclear cardiology procedures was only slightly lower in women (9.6 ± 4.5 mSv) than in men (10.3 ± 4.5 mSv; p < 0.001), with a difference of only 0.3 mSv in a multivariable model adjusting for patients' age and weight. Stress-only imaging was performed more frequently in women (12.5% vs. 8.4%; p < 0.001); however, camera-based dose reduction strategies were used less frequently in women (58.6% vs. 65.5%; p < 0.001). CONCLUSIONS: Despite significant worldwide variation in best practice use and radiation doses from nuclear cardiology procedures, only small differences were observed between genders worldwide. Regional variations noted in myocardial perfusion imaging use and radiation dose offer potential opportunities to address gender-related differences in delivery of nuclear cardiology care.

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Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

April 2016

Volume

9

Issue

4

Start / End Page

376 / 384

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Registries
  • Radiopharmaceuticals
  • Radiation Exposure
  • Radiation Dosage
  • Positron-Emission Tomography
  • Odds Ratio
 

Citation

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Shi, L., Dorbala, S., Paez, D., Shaw, L. J., Zukotynski, K. A., Pascual, T. N. B., … INCAPS Investigators Group, . (2016). Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry. JACC Cardiovasc Imaging, 9(4), 376–384. https://doi.org/10.1016/j.jcmg.2016.01.001
Shi, Lynn, Sharmila Dorbala, Diana Paez, Leslee J. Shaw, Katherine A. Zukotynski, Thomas N. B. Pascual, Ganesan Karthikeyan, et al. “Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry.JACC Cardiovasc Imaging 9, no. 4 (April 2016): 376–84. https://doi.org/10.1016/j.jcmg.2016.01.001.
Shi L, Dorbala S, Paez D, Shaw LJ, Zukotynski KA, Pascual TNB, et al. Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry. JACC Cardiovasc Imaging. 2016 Apr;9(4):376–84.
Shi, Lynn, et al. “Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry.JACC Cardiovasc Imaging, vol. 9, no. 4, Apr. 2016, pp. 376–84. Pubmed, doi:10.1016/j.jcmg.2016.01.001.
Shi L, Dorbala S, Paez D, Shaw LJ, Zukotynski KA, Pascual TNB, Karthikeyan G, Vitola JV, Better N, Bokhari N, Rehani MM, Kashyap R, Dondi M, Mercuri M, Einstein AJ, INCAPS Investigators Group. Gender Differences in Radiation Dose From Nuclear Cardiology Studies Across the World: Findings From the INCAPS Registry. JACC Cardiovasc Imaging. 2016 Apr;9(4):376–384.
Journal cover image

Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

April 2016

Volume

9

Issue

4

Start / End Page

376 / 384

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Sex Factors
  • Risk Factors
  • Risk Assessment
  • Registries
  • Radiopharmaceuticals
  • Radiation Exposure
  • Radiation Dosage
  • Positron-Emission Tomography
  • Odds Ratio