A study published in the journal Circulation: Cardiovascular Imaging found that switching from isotope technetium-99m to thallium-201 may raise long-term costs, testing and radiation dose. Researchers at the University of Ottawa Heart Institute collected data from 7,402 consecutive patients who underwent SPECT MPI before, during and after the institute's substitution of Tl-201 during a shortage of Tc-99m. False positives were higher with Tl-201, and the isotope "was associated with a significant increase (9.8%) in downstream resource utilization amounting to a cost increase of $74.25/patient," researchers said.

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