Nuclear cardiology in Iran in 2002 [Persian]

Aim: Few nuclear cardiology surveys were published in the literature, mostly from developed countries. The aim of this study is to perform a nuclear cardiology survey in Iran. This may lead to better decision making and programming. Methods and Materials: A questionnaire was sent by mail or e-mail to all nuclear medicine centers in Iran asking for details of nuclear cardiology practice in year 2002. Also ownership of the centers, number and type of gamma cameras and number of cardiac studies in each week were recorded. Some centers were studied using telephone interviews. Results: From 79 nuclear medicine centers in Iran, 55 centers (69.6%) filled the questionnaire including 28 centers in Tehran and 27 centers in other cities. Among them 27 centers were private clinics. There was 69 gamma cameras in these centers, 62.3% with SPECT capability. It is estimated that we may have 100 gamma cameras in Iran. About 85.5% of centers perform cardiac studies routinely. Tc-99m-MIBI is used in more than 85.7% of the studies and some centers do not use Tl-201. Pharmacological stress with infusion of Dipyridamole is used in 56.7% of the studies and treadmill is the main type of physical exercise (40.2%). SPECT technique was used in 93% of studies including 2.5% of gated SPECT. About 64.3% of centers used two day protocol for imaging. Our study showed that about 65594 cardiac studies were done in Iran each year with myocardial perfusion scan accounting for about 99.2% of the studies. Considering population of the country (About 65 millions) nuclear cardiology activity will be about 1.01 study/1000/year. For viability assessment, Tl-201 with rest redistribution technique is used in 10.7% of cases while re-injection is used in 29.8% of cases and TNG augmented Tc-99m-MIBI injection at rest in 59.5%. Discussion: Activity of nuclear cardiology is about 15 studies/1000 population/year in USA and 2.2 studies/1000/year in Europe. Although it is not uniformly practiced in different countries of Europe, however the numbers indicate that nuclear cardiology is underutilized in Iran (Less than half of the European mean). Education of the physicians as well as upgrading gamma cameras will improve practice of nuclear cardiology in Iran.