Setting up a myocardial perfusion scintigraphy service: clinical and business aspects

Prepared jointly by the British Cardiac Society, the British Nuclear Cardiology Society, and the British Nuclear Medicine Society

Correspondence to:
Correspondence to:
Dr Andrew D Kelion
Nuclear Medicine Department, Harefield Hospital, Hill End Road, Harefield, Middlesex UB9 6JH, UK; A.Kelion@rbh.nthames.nhs.uk

Abbreviations: AC, attenuation correction; ALARA, as low as reasonably achievable; ARSAC, Administration of Radioactive Substances Advisory Committee; ASNC, American Society of Nuclear Cardiology; BCS, British Cardiac Society; BNCS, British Nuclear Cardiology Society; BNMS, British Nuclear Medicine Society; CAD, coronary artery disease; CCST, certificate of completion of specialist training; CHAI, Committee for Healthcare Audit and Improvement; CMR, cardiac magnetic resonance (imaging); CT, computed tomography; DEFRA, Department of Environment, Food and Rural Affairs; DGH, district general hospital; EA, Environment Agency; EBCT, electron beam computed tomography; echo, echocardiography; EMPIRE, economics of myocardial perfusion imaging in Europe; HSE, Health and Safety Executive; IRMER, Ionising Radiation (Medical Exposures) Regulations; IRR, Ionising Radiations Regulations; IPEM, Institute of Physics and Engineering in Medicine; JCHMT, Joint Committee for Higher Medical Training; MARS, Medicines (Administration of Radioactive Substances) Regulations; MCE, myocardial contrast echocardiography; MPS, myocardial perfusion scintigraphy; nGMS, new General Medical Services (Contract); NHS, National Health Service; NICE, National Institute for Health and Clinical Excellence; NatPACT, national primary and care trust; NPC, national prescribing centre; NSF, National Service Framework; PACS, picture archiving communication systems; PALS, Patient Advice and Liaison Service; PCT, primary care trust; PEC, Professional Executive Committee; PET, positron emission tomography; QA, quality assurance; RAMRoad, Radioactive Materials (Road Transport) Regulations; RIS, radiology information systems; RPA, radiation protection advisor; RPS, radiation protection supervisor; RSA, Radioactive Substances Act; SON, summary of need; SPECT, single photon emission computed tomography; ^99mTc, technetium-99m; ²⁰¹Tl, thallium-201; WTE, whole time equivalent

Keywords: myocardial perfusion scintigraphy; service; British Cardiac Society; British Nuclear Cardiology Society; British Nuclear Medicine Society

The first 150 words of the full text of this article appear below.

1 INTRODUCTION AND OVERVIEW

Myocardial perfusion scintigraphy (MPS) has been available as a valuable tool in the investigation of patients with known or suspected coronary artery disease (CAD) for more than two decades. However, in notable contrast to the situation in the USA and parts of mainland Europe, MPS has been slow to establish itself in routine clinical practice in the UK. The National Institute for Health and Clinical Excellence (NICE) has recently completed a technology appraisal of MPS, with positive findings. The implication is that there ought to be an approximately fourfold increase in the provision of nuclear cardiology in England and Wales, with an estimated capital cost of £18 million and an annual revenue cost of £27 million.

MPS is an effective and cost effective investigation, but requires appropriate expertise and resources. The purpose of this document is to provide clinicians and managers who have little or no experience of MPS with . . . [Full text of this article]

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