Nonperfusion applications in nuclear cardiology: Report of a task force of the American Society of Nuclear Cardiology

In conclusion, there seems to be a combination of factors that have contributed to the underutilization of nonperfusion applications of nuclear cardiology. For some procedures (i.e., infarct-avid imaging, probe radiocardiography, and functional evaluation with mental stress) there is a perceived lack of clinical application. For these, further clinical validation and education of referring physicians is necessary. Other nonperfusion studies (i.e., equilibrium RNV) have not kept pace technologically with competing modalities. For these, camera and computer manufacturers should be encouraged to develop and implement appropriate new hardware and software. For others (i.e., 123I MIBG “nerve” imaging and fatty acid analog metabolic imaging) radiopharmaceutical availability, particularly in the United States, is severely limited. For these, radiopharmaceutical companies should be encouraged to sponsor clinical trials validating clinical efficacy and cost-effectiveness, and if justified, appropriate applications should be filed with federal agencies. Last, and perhaps most important, physicians practicing nuclear cardiology must be motivated to embrace these nonperfusion radionuclide applications when appropriate, target patient populations in their institutions who will most benefit, and convince referring physicians of the clinical efficacy and cost effectiveness.