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'''Cardiac PET''' (or ''cardiac [[positron emission tomography]]'') is a form of [[medical imaging|diagnostic imaging]] in which the presence of [[cardiovascular disease|heart disease]] is evaluated using a [[PET scanner]]. [[Intravenous injection]] of a [[radiotracer]] is performed as part of the scan. Commonly used radiotracers are [[Rubidium-82]], [[Nitrogen-13]] ammonia and [[Oxygen-15]] water.<ref>{{Cite journal | last=Ghosh | first=N |author2=Rimoldi OE |author3=Beanlands RS |author4=Camici PG | title=Assessment of myocardial ischaemia and viability: role of positron emission tomography | journal=European Heart Journal | volume=31 | issue=24 | pages=2984–2995 |date=December 2010 | pmid=20965888 | doi=10.1093/eurheartj/ehq361 | doi-access=free }}</ref>
'''Cardiac PET''' (or ''cardiac [[positron emission tomography]]'') is a form of [[medical imaging|diagnostic imaging]] in which the presence of [[cardiovascular disease|heart disease]] is evaluated using a [[PET scanner]]. [[Intravenous injection]] of a [[radiotracer]] is performed as part of the scan. Commonly used radiotracers are [[Rubidium-82]], [[Nitrogen-13]] ammonia and [[Oxygen-15]] water.<ref>{{Cite journal | last=Ghosh | first=N |author2=Rimoldi OE |author3=Beanlands RS |author4=Camici PG | title=Assessment of myocardial ischaemia and viability: role of positron emission tomography | journal=European Heart Journal | volume=31 | issue=24 | pages=2984–2995 |date=December 2010 | pmid=20965888 | doi=10.1093/eurheartj/ehq361 | doi-access=free }}</ref>


==Uses==
Cardiac Pet scan can assess both blood flow<ref>{{Cite web|title=Blood Flow Parameter|url=https://www.sciencedirect.com/topics/medicine-and-dentistry/blood-flow-parameter|website=ScienceDirect, The leading platform of peer-reviewed literature that helps you move your research forward.|language=en|access-date=2020-09-10}}</ref> and [[metabolism]] accurately. In patients with blocked coronaries, Cardiac PET scan can influence the choice between [[bypass surgery]] and [[angioplasty]]. More importantly, it can be used to predict whether depressed heart function can improve after [[revascularization]].
Cardiac PET-CT scan can assess blood flow, [[metabolism]], inflammation, innervation, and receptor density accurately. Besides, it is also useful to detect heart conditions such as [[coronary artery disease]], [[cardiac amyloidosis]], and [[cardiac sarcoidosis]].<ref name="Di Carli 2022">{{Cite book |last=Di Carli |first=Marcelo F |url=https://link.springer.com/10.1007/978-3-662-64499-7 |title=IAEA Atlas of Cardiac PET/CT: A Case-Study Approach |date=2022 |publisher=Springer Berlin Heidelberg |isbn=978-3-662-64498-0 |editor-last=Di Carli |editor-first=Marcelo F. |location=Berlin, Heidelberg |language=en |doi=10.1007/978-3-662-64499-7 |editor-last2=Dondi |editor-first2=Maurizio |editor-last3=Giubbini |editor-first3=Raffaele |editor-last4=Paez |editor-first4=Diana}}</ref>
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== Who should have Cardiac PET ==
==Radiopharmaceuticals==
Rubidium-82 is produced from the decay of Strontium-82 through [[electron capture]] in a generator. It is used to access the blood vessels supplying the heart. Strontium-82 has a half-life of 25.5 days while Rubidium-82 has a half-life of 76 seconds. Heart muscles can take up Rubidium-82 efficiently through [[sodium–potassium pump]]. Compared with [[Technetium-99m]], Rubidium-82 has higher uptake by the heart muscles. However, Rubidium-82 has lower uptake by heart muscles when compared to N-13 ammonia. But the positron energy emitted by Rubidium-82 is higher than N-13 ammonia and [[Fluorodeoxyglucose (18F)]]. On the other hand, the [[positron]] range (the distance travelled by a positron from its production site until its [[annihilation]] with an electron) is longer when compared to other radiopharmaceuticals, causing reduced [[image resolution]].<ref name="Di Carli 2022"/>

== Indications ==
* Patients with many risk factors e.g. [[hypertension]], [[high cholesterol]], smoking habit , [[diabetes]], [[obesity]], high stress occupation, family history of heart attack
* Patients with many risk factors e.g. [[hypertension]], [[high cholesterol]], smoking habit , [[diabetes]], [[obesity]], high stress occupation, family history of heart attack
* Patients who are unable to exercise
* Patients who are unable to exercise
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* Patients with abnormal [[ECG]] or [[treadmill]]
* Patients with abnormal [[ECG]] or [[treadmill]]


== Requirements to perform Cardiac PET imaging include ==
== Requirements ==
* Facility: taking into consideration clinical workflow, as well as regulatory requirements such as requisite shielding from radiation exposure
* Facility: taking into consideration clinical workflow, as well as regulatory requirements such as requisite shielding from radiation exposure
* Capital equipment: PET or PET/CT scanner
* Capital equipment: PET or PET/CT scanner

Revision as of 17:07, 7 January 2023

Cardiac PET
ICD-10-PCSC23G, C23Y
OPS-301 code3-741

Cardiac PET (or cardiac positron emission tomography) is a form of diagnostic imaging in which the presence of heart disease is evaluated using a PET scanner. Intravenous injection of a radiotracer is performed as part of the scan. Commonly used radiotracers are Rubidium-82, Nitrogen-13 ammonia and Oxygen-15 water.[1]

Uses

Cardiac PET-CT scan can assess blood flow, metabolism, inflammation, innervation, and receptor density accurately. Besides, it is also useful to detect heart conditions such as coronary artery disease, cardiac amyloidosis, and cardiac sarcoidosis.[2]

Radiopharmaceuticals

Rubidium-82 is produced from the decay of Strontium-82 through electron capture in a generator. It is used to access the blood vessels supplying the heart. Strontium-82 has a half-life of 25.5 days while Rubidium-82 has a half-life of 76 seconds. Heart muscles can take up Rubidium-82 efficiently through sodium–potassium pump. Compared with Technetium-99m, Rubidium-82 has higher uptake by the heart muscles. However, Rubidium-82 has lower uptake by heart muscles when compared to N-13 ammonia. But the positron energy emitted by Rubidium-82 is higher than N-13 ammonia and Fluorodeoxyglucose (18F). On the other hand, the positron range (the distance travelled by a positron from its production site until its annihilation with an electron) is longer when compared to other radiopharmaceuticals, causing reduced image resolution.[2]

Indications

Requirements

  • Facility: taking into consideration clinical workflow, as well as regulatory requirements such as requisite shielding from radiation exposure
  • Capital equipment: PET or PET/CT scanner
  • Radiopharmaceutical: Rubidium-82 generator system or close access to cyclotron produced isotopes such as Nitrogen-13 ammonia
  • Personnel: including specially trained physician, radiographers, radiation safety supervisors and optional nursing support
  • Operations: stress test monitoring, as well as emergency response equipment, processing and review workstations, administrative and support personnel are additional considerations

References

  1. ^ Ghosh, N; Rimoldi OE; Beanlands RS; Camici PG (December 2010). "Assessment of myocardial ischaemia and viability: role of positron emission tomography". European Heart Journal. 31 (24): 2984–2995. doi:10.1093/eurheartj/ehq361. PMID 20965888.
  2. ^ a b Di Carli, Marcelo F (2022). Di Carli, Marcelo F.; Dondi, Maurizio; Giubbini, Raffaele; Paez, Diana (eds.). IAEA Atlas of Cardiac PET/CT: A Case-Study Approach. Berlin, Heidelberg: Springer Berlin Heidelberg. doi:10.1007/978-3-662-64499-7. ISBN 978-3-662-64498-0.
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