title: Myocardial perfusion scintigraphy in Germany in 2009: utilization and state of the practice.
abstract: OBJECTIVE
  Since 2006, the working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine, in cooperation with the working group Nuclear Cardiology of the German Cardiac Society, has been surveying the utilization and technical realization of myocardial perfusion scintigraphy (MPS) in Germany. This paper presents the results of the reporting year 2009.
  
  
  METHODS
  A total of 291 centres participated in the inquiry, including 179 private practices (PP), 86 hospitals (HO) and 26 university hospitals (UH).
  
  
  RESULTS
  MPS of 98,103 patients were reported. The MPS numbers per million population (pmp) were estimated at 2,360; 76% of the MPS were performed in PP, 17% in HO and 7% in UH. The ratio of MPS to coronary angiography to revascularization was 0.5 to 2.3 to 1. Data from 134 centres which participated in the surveys from 2005 to 2009 showed a decrease in MPS utilization of 2.2%. Nearly half of the MPS were requested by ambulatory care cardiologists. Of all MPS studies, 89% were conducted with (99m)Tc perfusion tracers. Ergometry was the preferred stress test (69%). Adenosine was used in 16%, adenosine + exercise in 7%, dipyridamole in 3%, dipyridamole + exercise in 5% and dobutamine in <1%. Gated single proton emission computed tomography (SPECT) acquisition was performed in 56% of all rest MPS and in 56% of all stress MPS. Both rest and stress MPS were ECG gated in 41%. Only 33% of the centres always performed a quantification of the perfusion studies, whereas 51% did not apply any quantification; 4% of the MPS studies were corrected for attenuation, and 17 centres used transmission sources of 12 CT-based systems.
  
  
  CONCLUSIONS
  A scan activity of 2,380 MPS pmp is in the upper third of the European range. The ratios to coronary angiography and to revascularization suggest that angiography dominates diagnosis and management of coronary artery disease (CAD). The clinical and technical realizations reveal that the predominant goals of further trainings to optimize MPS are in the field of gated SPECT and quantitative perfusion SPECT.
authors.affiliation: Institute of Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital of Ruhr University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany. olindner@hdz-nrw.de
authors.forename: Oliver
authors.initials: O
authors.lastname: Lindner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Burchert
authors.forename: Frank M
authors.initials: FM
authors.lastname: Bengel
authors.forename: Rainer
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Jürgen
authors.initials: J
authors.lastname: Vom Dahl
authors.forename: Michael
authors.initials: M
authors.lastname: Schäfers
mesh_terms: D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D005858:Germany; D006801:Humans; D007091:Image Processing, Computer-Assisted; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000706:statistics & numerical data*; D019275:Radiopharmaceuticals; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013312:Stress, Physiological; D011795:Surveys and Questionnaires
chemical_list: D019275:Radiopharmaceuticals