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May 23, 2013

Minimizing Radiation Exposure During Nuclear Stress Tests

With better education, providers can help reduce risk of radiation exposure for patients undergoing these types of tests.

Each year, more than 10 million nuclear stress tests are performed to diagnose and guide treatment in patients with heart disease. Nuclear stress tests use imaging to see how the heart performs both during physical activity and at rest, which can help diagnose heart disease, evaluate the severity of a heart condition, and help guide treatment plans. Although nuclear stress tests are generally safe, they do expose patients to radiation and slightly increase cancer risk in patients. Fortunately, there are many ways to help minimize exposure to radiation from nuclear stress tests, like by ensuring that the imaging is necessary and by using the safest imaging technique available. But according to a study published in the Journal of the American Medical Association, current practices may be exposing patients to unnecessarily high doses of radiation and increasing cancer risk.

This study analyzed surveys from 374 physicians, technicians, and other healthcare providers across the country, which collected information on their nuclear stress test practices. Overall, only 51% of respondents used at least one strategy to reduce radiation exposure, like using newer imaging or a screening process that helps identify patients who truly need the in-depth testing. In fact, only 7.2% of respondents utilized this screening strategy, which has been shown to decrease radiation exposure by as much as 75%. Also, 15.6% of respondents used a type of testing that exposes patients to especially high doses of radiation.

Although these findings are troubling, exposing this missed opportunity to reduce radiation exposure will undoubtedly help improve practices in the future. It’s clear that providers conducting these tests must be better educated on techniques that can help reduce radiation exposure, and begin using these techniques more widely. Rather than half of providers taking precautions that help reduce radiation exposure, all physicians and technicians performing stress tests should use these techniques whenever possible. By taking steps to educate providers on nuclear stress tests, we can ultimately help reduce radiation exposure for patients and minimize cancer risk that comes along with these types of tests.

Questions for You to Consider

  • What is a nuclear stress test?
  • Nuclear stress tests utilize imaging of the heart during physical activity and at rest to see how the heart performs in different states. Results from this imaging can help diagnose heart disease, evaluate the severity of heart conditions, and help guide treatment plans. Although nuclear stress tests are generally safe, patients undergoing these tests are exposed to radiation, which can slightly increase cancer risk.
  • What do results of a nuclear stress test show?
  • Nuclear stress tests help diagnose heart disease and provide important information that can help guide treatment plans for patients. Since imaging is taken during exercise and at rest, the test will show whether a patient has normal blood flow during exercise, at rest, or both. It can also show if there is scar tissue in the heart, like from a heart attack.

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Nuclear stress tests are tests that use a small dose of radioactive solution to track blood flow to the heart in order to evaluate heart function during both physical activity and rest.

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