Optimizing the Diagnosis of ATTR-CM: Updates in Imaging and Best Practices-ASNC Quality Metrics for Cardiac Amyloid Radionuclide Imaging

ASNC Quality Metrics for Cardiac Amyloid Radionuclide Imaging

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The American Society of Nuclear Cardiology's document outlines new quality metrics for cardiac amyloid radionuclide imaging (CARI), with an emphasis on enhancing the quality of diagnostic imaging for cardiac amyloidosis. The document presents 15 quality metrics classified under four main axes: Appropriate indications, Patient experience and workflow, Instrumentation and protocols, and Interpretation and reporting.<br /><br />With the increasing application of CARI, particularly in diagnosing transthyretin amyloid cardiomyopathy (ATTR-CM), ensuring quality is essential. Appropriate patient selection for CARI based on specific clinical criteria can optimize diagnostic accuracy. For instance, CARI should be avoided in patients already diagnosed with light chain amyloidosis (AL amyloidosis) unless there's a suspicion of concomitant ATTR-CM. Importantly, the document stresses using single-photon emission computed tomography (SPECT) rather than planar imaging for interpreting results, to mitigate issues caused by blood pool tracer activity.<br /><br />Patient education, ensuring comprehensive understanding of the procedure, and improving timely access are pivotal. This encompasses providing patient-friendly educational materials and limiting unnecessary radiation exposure by avoiding radionuclide injection without subsequent imaging. Addressing equipment maintenance proactively can reduce technical failures during appointments.<br /><br />The metrics also emphasize consistent reporting. Each report should include technical details like the dose administered, timing, and imaging technique for transparency and to support appropriate clinical decision-making. Laboratories are encouraged to implement peer-review quality control to maintain high standards in interpretation and reporting. <br /><br />Overall, these metrics have the potential to not only sustain but elevate the quality of nuclear cardiology services, which will, in turn, improve clinical outcomes for patients with suspected cardiac amyloidosis.

Keywords

cardiac amyloid radionuclide imaging

quality metrics

cardiac amyloidosis

diagnostic imaging

transthyretin amyloid cardiomyopathy

SPECT

patient education

technical details

peer-review quality control

nuclear cardiology services