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

Eur J Nucl Med Mol Imaging. 2024 Jul;51(8):2247-2259. doi: 10.1007/s00259-024-06597-x. Epub 2024 Jan 15.

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.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Cardiovascular Diseases / diagnostic imaging
  • Evidence-Based Medicine
  • Humans
  • Multimodal Imaging / standards
  • Nuclear Medicine / standards
  • Practice Guidelines as Topic*