ACCF/ASNC appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI): a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group and the American Society of Nuclear Cardiology endorsed by the American Heart Association.
Under the auspices of the American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC), an appropriateness review was conducted for radionuclide cardiovascular imaging (RNI), specifically gated single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI). The review assessed the risks and benefits of the imaging test for several indications or clinical scenarios and scored them based on a scale of 1 to 9, where the upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The mid range (4 to 6) implies that the test may be generally acceptable and may be a reasonable approach for the indication. The indications for this review were primarily drawn from existing clinical practice guidelines and modified based on discussion by the ACCF Appropriateness Criteria Working Group and the Technical Panel members who rated the indications. The method for this review was based on the RAND/UCLA approach for evaluating appropriateness, which blends scientific evidence and practice experience. A modified Delphi technique was used to obtain first- and second-round ratings of 52 clinical indications. The ratings were done by a Technical Panel with diverse membership, including nuclear cardiologists, referring physicians (including an echocardiographer), health services researchers, and a payer (chief medical officer). These results are expected to have a significant impact on physician decision making and performance, reimbursement policy, and future research directions. Periodic assessment and updating of criteria will be undertaken as needed.
Brindis
Ralph G
RG
Douglas
Pamela S
PS
Hendel
Robert C
RC
Peterson
Eric D
ED
Wolk
Michael J
MJ
Allen
Joseph M
JM
Patel
Manesh R
MR
Raskin
Ira E
IE
Hendel
Robert C
RC
Bateman
Timothy M
TM
Cerqueira
Manuel D
MD
Gibbons
Raymond J
RJ
Gillam
Linda D
LD
Gillespie
John A
JA
Hendel
Robert C
RC
Iskandrian
Ami E
AE
Jerome
Scott D
SD
Krumholz
Harlan M
HM
Messer
Joseph V
JV
Spertus
John A
JA
Stowers
Stephen A
SA
D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*