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Societies: CAD best diagnosed, managed with myocardial perfusion PET
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Myocardial perfusion PET is the most useful imaging modality in the diagnosis and management of CAD, according to a position statement issued by two professional societies.
In the document, the American Society of Nuclear Cardiology and the Society of Nuclear Medicine and Molecular Imaging stated that myocardial perfusion PET should be the first-line test for all patients who meet appropriate criteria for a stress-imaging test, cannot complete a diagnostic level of exercise and require pharmacologic stress.
According to the statement’s authors, myocardial perfusion PET has high diagnostic accuracy, strong prognostic power, a low amount of radiation, quantification of myocardial blood flow, short acquisition protocols and consistent high-quality images.
Timothy M. Bateman
They also wrote that myocardial perfusion PET should be the recommended test under the following conditions: when previous stress imaging is equivocal, of poor quality or inconclusive; in high-risk patients in whom diagnostic errors translate into significant clinical implications; in patients whose body characteristics could affect image quality; and for younger patients who could benefit from reduction of lifetime radiation exposure.
According to the statement, myocardial perfusion PET exposes patients to radiation levels lower than some other radiation-based imaging modalities and well below those linked to long-term adverse effects.
“Among available noninvasive cardiac imaging options, the [two societies] have noted significant underutilization of myocardial perfusion PET relative to its demonstrated advantages for patients being assessed for suspected clinically important CAD, and to its current wide availability in the United States,” Timothy M. Bateman, MD, clinical professor of medicine, University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, and colleagues wrote in the statement. – by James Clark
Disclosure: Bateman reports receiving research grants from Astellas and GE Healthcare; receiving royalties from ExSPECT II Attenuation Correction and Imagen Pro/MD/Q/3D; serving on an advisory board for Lantheus; and being a salaried employee or owner of CVIT. Please see the full statement for a list of the other authors’ relevant financial disclosures.
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