title: Current status of nuclear cardiology practice in Latin America and the Caribbean.
abstract: The burden of cardiovascular diseases (CVDs) in the world is ever growing. They represent the first cause of death worldwide and in Latin America. Nuclear cardiology has a well-established role in the management of patient with CVDs and is being increasingly integrated into the healthcare systems in the region. However, there remains variability as to the infrastructure available across the countries, in terms of existing technology, radiopharmaceuticals, and human resources. The approximate number of gamma (γ) cameras in the region is 1348, with an average of 2.25 per million population; Argentina and Brazil having the largest number. Nearly 80% of the existing cameras are single-photon emission tomography (SPECT), of which 8% are hybrid SPECT-CT systems. Positron emission tomography technology is steadily increasing, and currently, there is an average of 0.25 scanners per million inhabitants, indicating that there is a potential to expand the capacities in order to cover the needs. Four countries have nuclear reactors for research purposes, which allow the production of technetium-99 m (Argentina, Chile, Mexico and Peru), while four (Argentina, Brazil, Cuba, and Mexico) assemble99Mo-99mTc generators. As for the nuclear cardiology studies, about 80% of studies performed are gated SPECT myocardial perfusion imaging; less than 10% are multi-gated acquisition (mainly for evaluation of cardiac toxicity in cancer patients), and the other 10% correspond to other types of studies, such as viability detection, and adrenergic innervation studies with123I-MIBG. Physical stress is preferred, when possible, based on the clinical condition of the patient. Regarding human resources, there is an average of 1.1 physicians and 1.3 technologists per γ camera, with 0.1 medical physicists and 0.1 radiopharmacists per center in the region. The future of nuclear cardiology in Latin America and the Caribbean is encouraging, with great potential and possibilities for growth. National, regional, and international cooperation including support from scientific societies and organizations such as International Atomic Energy Agency, American Society of Nuclear Cardiology, and Latin American Association of Biology and Nuclear Medicine Societies, as well as governmental commitment are key factors for the development of the specialty. A multimodality approach in cardiac imaging will contribute to a better management of patients with CVDs.
authors: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors: Diana
authors: D
authors: Paez
authors: Nuclear Medicine Department, Institute of Cardiology, 17 No. 702, Vedado, 10 400, Havana, La Habana, Cuba. peix@infomed.sld.cu.
authors: Amalia
authors: A
authors: Peix
authors: Nuclear Medicine Unit, Radiology Department, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Pilar
authors: P
authors: Orellana
authors: Quanta Diagnostico e Terapia, Curitiba, Brazil.
authors: Joao
authors: J
authors: Vitola
authors: Nuclear Medicine Service, Asociación Española, Montevideo, Uruguay.
authors: Fernando
authors: F
authors: Mut
authors: Cardiology Institute, Fundación Cardioinfantil, Bogotá, Colombia.
authors: Claudia
authors: C
authors: Gutiérrez
authors: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors: Crosby
authors: C
authors: Plaza
authors: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors: Tarik
authors: T
authors: Becic
authors: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors: Maurizio
authors: M
authors: Dondi
authors: Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
authors: Enrique
authors: E
authors: Estrada
mesh_terms: D057791:Cardiac Imaging Techniques / Q000706:statistics & numerical data*; D002309:Cardiology / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017691:Caribbean Region / Q000453:epidemiology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D009683:Nuclear Medicine / Q000706:statistics & numerical data; D015995:Prevalence; D011877:Radionuclide Imaging / Q000706:statistics & numerical data*; D014600:Utilization Review
keywords: Caribbean; Latin America; Nuclear cardiology; PET; SPECT; cardiovascular diseases