THE USE OF RADIONUCLIDE INVESTIGATIONS BY CARDIOLOGISTS - RESULTS OF A FRENCH INQUIRY

The authors report the results of an enquiry carried out amongst Frenc h cardiologists to determine their opinion about radionuclide investig ations in cardiological practice. Of the 5,050 cardiologists contacted , 1,431 (28.3%) replied. The cardiologists were attracted by the non-i nvasive nature (84%) of radionuclide techniques and their complementar ity with other methods of investigation (74%) but regretted their cost (55%), their lick of availability in emergencies (35%) and, in genera l, their difficult of access (30%). Only 38% of the cardiologists who replied used radionuclide investigation on an everyday basis, this bei ng impossible for some because of the distance to the nearest centre w ith these facilities (on average 32 km but exceeding 50 km in 29% of c ases, and the delay before obtaining an appointment (average 13 days) which was often excessive, especially for myocardial scintigraphy (tha llium or equivalent). Each cardiologist prescribed an average of 5 myo cardial scintigraphies, 3 pulmonary scintigraphies and 2 radioisotopic ventriculography per month. These results seem to be an overestimatio n; in fact, radionuclide investigations are relatively underemployed, probably more because of the factors cited above than because of lack interest or quality, these latter two points being generally judged po sitively by the majority of cardiologists. Cardiologists require more from the conclusions of the investigation than a simple description of the images obtained. As with all other investigations that they perfo rm themselves, the interpretation of the results must take the clinica l context into consideration and form part of the diagnostic and thera peutic management of the patient. Idealy, this would require a greater number of physicians with a double cardiological and radionuclide tra ining, an objective which is opposed by the present medical curriculum in France.