Current techniques and practices for myocardial stress testing : a comparative survey between Malta and International nuclear medicine centres

Abstract

Objectives: The study compared cardiac scintigraphy stress scanning practices applied in a National Maltese Nuclear Medicine centre and in international centres. This was achieved through the design of an online survey which investigated participant knowledge of stress testing, and current procedural practice. Methods: An online survey comprising 12 questions was prepared using Survey Monkey. Professional Nuclear Medicine groups such as the Medical-Physics-Engineering community and Virtual Radiopharmacy were targeted. Access to the survey remained open for eight months during which a periodic reminder was sent to optimise the response rate. Forty-three members responded from across Europe and Australasia. Chi-square tests and comparisons between multiple responses using IBM SPSS 20 were used to evaluate the results. Information related to Maltese practice was collated separately for review and comparative purposes. Results: The online survey participants comprised United Kingdom [72%], other European countries [18%] and Australasia [9%]. The majority of respondents [n = 39] reported pharmacological stress testing as being performed either alone or in conjunction with exercise stress testing as the preferred option. Most participants [60%] were aware of local stress test protocols but had limited knowledge in relation to guidelines designed for cases where patients were not suitable for pharmacological stress testing. Conclusion: The survey provided information about procedures within participating centres for scintigraphic cardiac stress scanning. Differences were identified with regards to the preferred radiopharmaceutical tracers and procedural protocols. Further investigation of examination techniques is warranted, with the aim of increasing standardisation of protocol compliance and the application of more suitable practice.