Due to the pandemic, a steep fall in number of SPECT-MPI exams is noted

There has been a dramatic fall in the number of patients visiting health care centers during this pandemic especially the early phase of COVID-19, the reason being lockdown and people themselves avoided any unnecessary contact.

In the European Journal of Nuclear Medicine and Molecular Imaging, a study was published led by Dr. Fadi Hage (cardiologist at the University of Alabama at Birmingham) which stated that there has been a steep drop (80%) in the volume of SPECT myocardial perfusion imaging (MPI) studies during the peak of the COVID-19. The reason for this drop discussed under the study was the postponement of nonessential procedures by patients.

It was a retrospective study to assess the impact of the coronavirus pandemic on SPECT-MPI utilization, where a team of researchers compared a volume of SPECT-MPI for March and April of the year 2019 and 2020.

The study revealed that there was a drop of more than 80% in the number of SPECT-MPI scans performed during the peak of the pandemic. 

The researchers hypothesized that since SPECT-MPI is limited to the high-yield patients only thus a shift in the rate of abnormal SPECT-MPI exams can be expected. However surprisingly the results showed no significant increase in the rate of abnormal SPECT-MPI.

In a different study, it was found that during the pandemic CT lung cancer screening volume was down by almost 75%, while the rate of malignancies/positive screens rose by more than 250%.

In another study, Hage et al theorized that the patients who got SPECT-MPI during the pandemic would be at higher risk of a poor prognosis, which suggests that the percentage of abnormal results for 2020 will be higher compared to 2019. 

For the study, 210 patients who underwent SPECT-MPI in March and April of 2020 were compared with 1,106 who had SPECT-MPI during the same period in 2019. In their study, a review of referral patterns and the use of telemedicine was also included. 

When the results of the two cohort studies were compared, they revealed that there was a drop in the SPECT-MPI volume when compared between pre-pandemic and peak-pandemic periods and there was no significant change in the number of abnormal SPECT-MPI exams.

They also found that the likelihood of an abnormal result was not affected by the referral pattern whether an assessment was carried out via telemedicine or a face-to-face visit but the patients who were referred by cardiologists had shown more abnormal results.

Hage et al concluded that it “remains difficult to predict which patients will have abnormal SPECT-MPI even when providers and stress laboratories are forced to prioritize the performance of studies to high-yield patients.”