Multicenter intercomparison assessment of consistency of left ventricular function from a gated cardiac SPECT phantom

BACKGROUND: A multicenter intercomparison assessment was made of the variation in left ventricular (LV) volumes and ejection fractions (EFs) obtained from gated myocardial perfusion single photon emission computed tomography (SPECT) of the 3-dimensional AGATE (Amsterdam gated) cardiac phantom. METHODS AND RESULTS: The phantom was configured to produce 3 different standard end-systolic volume and end-diastolic volume combinations (50 mL and 120 mL, 90 mL and 160 mL, and 120 mL and 190 mL) with corresponding EF (58%, 44%, and 37%). Quantitative gated myocardial perfusion SPECT was performed with 39 SPECT systems in 35 departments. In the multicenter study, for all 3 filling conditions, a wide range of results was obtained. The EF was overestimated (by 1% to 15%), and both the end-systolic volume and end-diastolic volume were underestimated (by 1 to 65 mL). The extent of overestimation of EF was related to the extent of underestimation of the volumes and was independent of filling condition. The trend in error per center was comparable for all 3 filling conditions. Acquisition time per projection was the only independent predictor of the difference between measured and expected EF (P = .0001). CONCLUSIONS: Care should be taken before extrapolation of published and accepted cutoff values for LV EF and volumes in clinical decision making. Results should be validated in each center and monitored for accuracy and consistency over tim

A survey of guidelines in 27 EANM associated societies by the EANM Task Group on Quality Assurance and Standardisation

The main aim of the EANM Task Group on Quality Assurance and Standardisation is to develop harmonised clinical procedures that are accepted within Europe. In order to achieve an evidence-based analysis of guidelines in the 27 EANM member societies, a survey was conducted, A questionnaire in mid 1999 investigated three major questions: (1) current status of national guidelines in EANM member societies, (2) specification of the cover and level of these national guidelines, and (3) future desires for national, EANM and SNM guidelines. The complete response rate was 96% (26/27), Guidelines are required by 19 of 27-member societies and have been initiated by 16 member societies. Guidelines are provided by 13 member societies, generally in the national language. In ten societies, specialists other than nuclear medicine physicians, mostly physicists and radiopharmacists, take the lead on some guidelines. Moreover, in some national societies there is active collaboration with other medical societies when writing guidelines, particularly cardiology societies. Currently, only 18% of the necessary procedure guidelines are covered, Compared with a survey conducted in 1993 by the EANM Committee on Quality Assurance and Standardisation, slow progress has been made in this regard, but compared with a survey conducted by the same committee in 1996 in 23 EANM member societies, the number of member societies providing guidelines has approximately doubled, Moreover, 26 of 27 member societies share a commitment for future development of guidelines and 21 of 27 prefer EANM guidelines to national guidelines. The results of this questionnaire justify the need for close co-operation between EANM, EANM member societies, the EANM Task Group on "Quality Assurance and Standardisation" and the Guideline Committee of the SNM. The clinical priorities are considered to be cardiac, renal and brain procedures

131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging.

The aim of this document is to provide general information about mIBG scintigraphy in cancer patients. The guidelines describe the mIBG scintigraphy protocol currently used in clinical routine, but do not include all existing procedures for neuroendocrine tumours. The guidelines should therefore not be taken as exclusive of other nuclear medicine modalities that can be used to obtain comparable results. It is important to remember that the resources and facilities available for patient care may vary from one country to another and from one medical institution to another. The present guidelines have been prepared for nuclear medicine physicians and intend to offer assistance in optimizing the diagnostic information that can currently be obtained from mIBG scintigraphy. The corresponding guidelines of the Society of Nuclear Medicine (SNM) and the Dosimetry, Therapy and Paediatric Committee of the EANM have been taken into consideration, and partially integrated into this text. The same has been done with the most relevant literature on this topic, and the final result has been discussed within a group of distinguished experts