Content area
Objectives
This study aimed to evaluate the level of evidence of expert recommendations and guidelines for clinical indications and procedurals in hybrid nuclear cardiovascular imaging.
Methods
From inception to August 2023, a PubMed literature analysis of the latest version of guidelines for clinical hybrid cardiovascular imaging techniques including SPECT(/CT), PET(/CT), and PET(/MRI) was performed in two categories: (1) for clinical indications for all-in primary diagnosis; subgroup in prognosis and therapy evaluation; and for (2) imaging procedurals. We surveyed to what degree these followed a standard methodology to collect the data and provide levels of evidence, and for which topic systematic review evidence was executed.
Results
A total of 76 guidelines, published between 2013 and 2023, were included. The evidence of guidelines was based on systematic reviews in 7.9% of cases, non-systematic reviews in 47.4% of cases, a mix of systematic and non-systematic reviews in 19.7%, and 25% of guidelines did not report any evidence. Search strategy was reported in 36.8% of cases. Strengths of recommendation were clearly reported in 25% of guidelines. The notion of external review was explicitly reported in 23.7% of cases. Finally, the support of a methodologist was reported in 11.8% of the included guidelines.
Conclusion
The use of evidence procedures for developing for evidence-based cardiovascular hybrid imaging recommendations and guidelines is currently suboptimal, highlighting the need for more standardized methodological procedures.
Details
1 Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Le Kremlin Bicetre, France (GRID:grid.413784.d) (ISNI:0000 0001 2181 7253); Université Paris-Saclay, School of Medicine, Le Kremlin-Bicetre, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535); Université Paris-Saclay, Commissariat À L’énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Le Kremlin-Bicetre, France (GRID:grid.460789.4) (ISNI:0000 0004 4910 6535)
2 Ente Ospedaliero Cantonale, Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland (GRID:grid.469433.f) (ISNI:0000 0004 0514 7845); Università della Svizzera Italiana, Faculty of Biomedical Sciences, Lugano, Switzerland (GRID:grid.29078.34) (ISNI:0000 0001 2203 2861)
3 Georg-August University Göttingen, Universitätsmedizin Göttingen, Department of Nuclear Medicine, Gottingen, Germany (GRID:grid.7450.6) (ISNI:0000 0001 2364 4210)
4 BRFAA - Biomedical Research Foundation Academy of Athens, Athens, Greece (GRID:grid.417975.9) (ISNI:0000 0004 0620 8857)
5 University Hospital Zurich, Department of Nuclear Medicine, Cardiac Imaging, Zurich, Switzerland (GRID:grid.412004.3) (ISNI:0000 0004 0478 9977)
6 University of Edinburgh, Chancellors Building, British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, Edinburgh, UK (GRID:grid.4305.2) (ISNI:0000 0004 1936 7988)
7 University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Department of Medicine and Surgery, Bergamo, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754)
8 HeartClinic, Hirslanden Hospital Zurich, Zurich, Switzerland (GRID:grid.7563.7)
9 Fondazione Toscana/CNR Gabriele Monasterio, Pisa, Italy (GRID:grid.452599.6) (ISNI:0000 0004 1781 8976)
10 Université Catholique de Louvain, Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Brussels, Belgium (GRID:grid.7942.8) (ISNI:0000 0001 2294 713X)
11 University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, Groningen, the Netherlands (GRID:grid.4830.f) (ISNI:0000 0004 0407 1981)
12 APHM, La Timone Hospital, Department of Cardiology, Marseille, France (GRID:grid.411266.6) (ISNI:0000 0001 0404 1115)
13 Assistance Publique - Hôpitaux de Paris, Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Paris, France (GRID:grid.50550.35) (ISNI:0000 0001 2175 4109)
14 Uppsala University Hospital, Medical Imaging Centre, Uppsala, Sweden (GRID:grid.412354.5) (ISNI:0000 0001 2351 3333)
15 University Hospital Stuttgart, Department of Nuclear Medicine, Stuttgart, Germany (GRID:grid.411544.1) (ISNI:0000 0001 0196 8249)
16 Turku University Hospital and University of Turku, Heart Center, Turku, Finland (GRID:grid.410552.7) (ISNI:0000 0004 0628 215X)
17 University of Groningen, Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, Groningen, the Netherlands (GRID:grid.4830.f) (ISNI:0000 0004 0407 1981); University of Twente, Department of Biomedical Photonic Imaging, Faculty of Science and Technology, Enschede, the Netherlands (GRID:grid.6214.1) (ISNI:0000 0004 0399 8953)