Cardiac PET/CT Scan

What is a Cardiac PET Scan?

A Positron Emission Tomography (PET) scan of the heart is a noninvasive nuclear imaging test. It uses radioactive tracers (called radionuclides) to produce pictures of your heart. Adler Imaging uses cardiac PET scans to diagnose coronary artery disease (CAD) and damage due to a heart attack. PET scans can show healthy and damaged heart muscle. Adler Imaging also uses PET scans to help find out if you will benefit from a percutaneous coronary intervention (PCI) such as angioplasty and stenting, coronary artery bypass surgery (CABG) or another procedure.

Adler Imaging Quick Facts

• PET scans use radioactive material called tracers. Tracers mix with your blood and are taken up by your heart muscle.

• A PET scan shows if your heart is getting enough blood or if blood flow is reduced because of narrowed arteries. It also shows dead cells (scars) from a prior heart attack.

• A PET scan can help in determining if you’ll benefit from a cardiac procedure (PCI) or surgery to restore blood flow. The tracers used for PET scans can help identify injured but still living (viable) heart muscle that might be saved if blood flow is restored.

Why do doctors send patients to Adler Imaging for Cardiac PET Scans?

Doctors send patients to Adler Imaging for a PET scan because it is a very accurate way to diagnose coronary artery disease and detect areas of low blood flow in the heart. A PET scan can also identify dead tissue and injured tissue that’s still living and functioning. If the tissue is viable, the patient may benefit from a PCI or coronary artery bypass surgery.

At Adler Imaging, how does a Cardiac PET scan work?

Computer graphics can be used to create a 3-dimensional image of your heart from the thin-slice images.

The doctor will be able to tell if a patient’s heart muscle is functioning or (if the heart muscle isn’t working) if your heart muscle is still alive by how well it takes up and uses the different tracers. The doctor will also determine this by examining the images to find where the tracer is located. Viable heart tissue will take in more of the tracer than tissue that’s no longer viable. Different colors or degrees of brightness on the PET scan show different levels of tissue function.

Are there risks getting a cardiac PET?

Cardiac PET is safe for most people. The amount of radiation is small, and your body will get rid of it through your kidneys within about 24 hours. If you’re pregnant or think you might be pregnant, or if you’re a nursing mother, it could harm your baby.  Be sure to let your doctor know this.

How do I prepare for cardiac PET?

• Adler Imaging will inquire about any medicines being taken, including over-the-counter medicines, herbs and vitamins. You may be asked not to take them before the test.

• If you have diabetes and take insulin, Adler Imaging will inform you about how much insulin you should take before the scan and what you should eat. Your blood sugar levels will be monitored during the test. Test results are not always accurate in people with diabetes.

• At Adler Imaging, you will be asked to avoid certain foods and drinks, such as caffeine-containing drinks or alcohol, for 24 hours before your test.

• Don’t eat, and drink only water for 4 to 6 hours before your test.

• Wear comfortable, loose-fitting clothing, and don’t wear jewelry or other metal objects.

What happens during cardiac PET?

The Adler Imaging staff  perform the scan at our office at the Pavilion in Jenkintown, PA.

• The technologist will place small metal disks (electrodes) on your chest, arms and legs. The disks have wires that hook to a machine that records your electrocardiogram (ECG or EKG). The ECG keeps track of your heartbeat during the test and can signal the computer when to take a scan.

• The technologist will put an intravenous line (IV) in your arm. The tracer will be injected through the IV line.

• You’ll lie on a flat table that’s connected to the PET scanner and a computer. The table will slide into the scanner, which is shaped like a giant doughnut.

• Within the PET scanner, detectors record the radioactive patterns of the tracer in your heart. The information is transformed into images on a computer screen. Several scans are done over time to provide pictures of thin slices of your entire heart from all angles. It’s very important to hold completely still with your arms above your head while each scan is being done.

• Adler Imaging will take a baseline picture of your heart before the tracer is injected. This takes about 15 to 30 minutes. 

• Next, the tracer will be injected and your heart will be scanned again.

• If you will have a nuclear chemical stress test (also called a pharmacologic stress test), you’ll get a medicine that increases the blood flow in your heart, similar to what happens during exercise. These medicines may include adenosine, dipyridamole (Persantine) or dobutamine. Adler Imaging will examine how well your heart takes up the tracer before and after receiving the medicine.

• The test takes between 1 and 3 hours.

What happens after my PET scan?

• You can usually go back to your normal activities right away.

• Drink plenty of water for the next 24 hours to flush the radioactive material from your body.

• Make an appointment with your doctor to discuss the results of the test which will be sent over via Alder Imaging and next steps to take.

Why Ammonia?

ASNC / SNMMI position statement 

“Preferred:    First line preferred test for patients with known or suspected CAD and are unable to exercise.  There are no clinical scenarios where PET should not be considered a preferred test for these patients. 

Recommended:    

• Prior equivocal or inconclusive study

• Body habitus 

• High-risk patients

• Young patients with known CAD

• Multivessel or Microvascular disease” 

American Society of Nuclear Cardiology and Society of Nuclear Medicine and Molecular Imaging Joint Position Statement on the Clinical Indications for Myocardial Perfusion PET, Bateman et al. J Nucl Med 2016.116.180448