. 2024 Jul;51(8):2247-2259.

doi: 10.1007/s00259-024-06597-x. Epub 2024 Jan 15.

A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

Florent L Besson^{1

2

3}, Giorgio Treglia^{4

5}, Jan Bucerius⁶, Constantinos Anagnostopoulos⁷, Ronny R Buechel⁸, Marc R Dweck⁹, Paula A Erba¹⁰, Oliver Gaemperli¹¹, Alessia Gimelli¹², Olivier Gheysens¹³, Andor W J M Glaudemans¹⁴, Gilbert Habib¹⁵, Fabian Hyafil¹⁶, Mark Lubberink¹⁷, Christopher Rischpler¹⁸, Antti Saraste¹⁹, Riemer H J A Slart^{20

21}

Affiliations

¹ Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Le Kremlin Bicetre, France.
² School of Medicine, Université Paris-Saclay, Le Kremlin-Bicetre, France.
³ Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Université Paris-Saclay, Le Kremlin-Bicetre, France.
⁴ Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland.
⁵ Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland.
⁶ Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Gottingen, Germany.
⁷ BRFAA - Biomedical Research Foundation Academy of Athens, Athens, Greece.
⁸ Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
⁹ British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK.
¹⁰ Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
¹¹ HeartClinic, Hirslanden Hospital Zurich, Zurich, Switzerland.
¹² Fondazione Toscana/CNR Gabriele Monasterio, Pisa, Italy.
¹³ Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Université Catholique de Louvain, 1200, Brussels, Belgium.
¹⁴ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
¹⁵ Department of Cardiology, APHM, La Timone Hospital, Marseille, France.
¹⁶ Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, F75015, Paris, France.
¹⁷ Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden.
¹⁸ Department of Nuclear Medicine, University Hospital Stuttgart, Stuttgart, Germany.
¹⁹ Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
²⁰ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. r.h.j.a.slart@umcg.nl.
²¹ Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands. r.h.j.a.slart@umcg.nl.

PMID: 38221570
PMCID: PMC11178580
DOI: 10.1007/s00259-024-06597-x

A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

Florent L Besson et al. Eur J Nucl Med Mol Imaging. 2024 Jul.

. 2024 Jul;51(8):2247-2259.

doi: 10.1007/s00259-024-06597-x. Epub 2024 Jan 15.

Authors

Affiliations

¹ Department of Nuclear Medicine-Molecular Imaging, DMU SMART IMAGING, Hôpitaux Universitaires Paris-Saclay, AP-HP, CHU Bicêtre, Le Kremlin Bicetre, France.
² School of Medicine, Université Paris-Saclay, Le Kremlin-Bicetre, France.
³ Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), Inserm, BioMaps, Université Paris-Saclay, Le Kremlin-Bicetre, France.
⁴ Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland.
⁵ Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland.
⁶ Department of Nuclear Medicine, Georg-August University Göttingen, Universitätsmedizin Göttingen, Gottingen, Germany.
⁷ BRFAA - Biomedical Research Foundation Academy of Athens, Athens, Greece.
⁸ Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
⁹ British Heart Foundation Centre for Cardiovascular Science, Edinburgh Heart Centre, University of Edinburgh, Chancellors Building, Little France Crescent, Edinburgh, UK.
¹⁰ Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy.
¹¹ HeartClinic, Hirslanden Hospital Zurich, Zurich, Switzerland.
¹² Fondazione Toscana/CNR Gabriele Monasterio, Pisa, Italy.
¹³ Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Institut Roi Albert II, Université Catholique de Louvain, 1200, Brussels, Belgium.
¹⁴ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
¹⁵ Department of Cardiology, APHM, La Timone Hospital, Marseille, France.
¹⁶ Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, F75015, Paris, France.
¹⁷ Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden.
¹⁸ Department of Nuclear Medicine, University Hospital Stuttgart, Stuttgart, Germany.
¹⁹ Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
²⁰ Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. r.h.j.a.slart@umcg.nl.
²¹ Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands. r.h.j.a.slart@umcg.nl.

PMID: 38221570
PMCID: PMC11178580
DOI: 10.1007/s00259-024-06597-x

Abstract

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.

Keywords: Cardiovascular guidelines; Evidence-based practice; Hybrid imaging; Positron emission tomography; Recommendations.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1**
Questionnaire for the collection and use of evidence for guidelines

**Fig. 2**
Flow diagram for literature screening

**Fig. 4**
Quality assessment of the guidelines

See this image and copyright information in PMC

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A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

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A systematic review for the evidence of recommendations and guidelines in hybrid nuclear cardiovascular imaging

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Abstract

Conflict of interest statement

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