Multiple Testing, Cumulative Radiation Dose, and Clinical Indications in Patients Undergoing Myocardial Perfusion Imaging

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Abstract
Utilization of medical imaging has grown rapidly in recent years.1 Along with the benefits patients have received from medical imaging has come an increase in the burden of ionizing radiation associated with many such tests and the attendant potential risks of cancer. The National Council on Radiation Protection and Measurements has estimated that the per capita dose of medical radiation in the United States increased nearly 6-fold from the early 1980s to 2006.2 This increased medical radiation burden has raised public health concerns, leading to a US Food and Drug Administration initiative to reduce unnecessary radiation exposure from medical imaging,3 with one of its focuses being nuclear imaging, and discussion in Congress of new legislation to regulate medical radiation.4