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Cardiac PET and PET/CT Imaging pp 135–150Cite as

PET and Integrated PET/CT Myocardial Imaging Protocols and Quality Assurance

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Abstract

The primary clinical applications of positron emission tomography (PET) myocardial perfusion imaging are to diagnose, localize, and quantify the severity of coronary artery stenoses. As a result, most clinical applications of myocardial perfusion imaging are performed in conjunction with stress testing. Exercise stress testing with single photon emission computed tomography (SPECT) is widely used in the evaluation of patients with known or suspected coronary artery disease.1–3 Although exercise stress testing offers several advantages, the short physical half-life of most PET radiotracers makes it logistically impractical for use in conjunction with PET imaging. In addition, a significant proportion of patients referred for stress imaging are unable to exercise adequately due to difficulties with ambulation related to prior stroke, peripheral vascular disease, orthopedic problems or deconditioning.3 Submaximal exercise can reduce test sensitivity for detection of ischemic heart disease and should be avoided. Pharmacologic stress testing with dipyridamole,4,5 adenosine4,6,7 or dobutamine infusions8–9 are useful to evaluate patients that are unable to exercise or have suboptimal exercise capicity.3 Chapter 9 provides a detailed discussion of stress protocols. The aim of this chapter is to provide a review of clinically useful imaging protocols for evaluation of CAD, along with guidelines for quality control of PET and PET/CT images. For a better understanding of protocols for PET myocardial perfusion imaging, the reader should be familiar with basic principles of PET and PET/CT (discussed in Chapters 1 and 3) and PET radiopharmaceuticals (discussed in Chapter 5).

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Authors and Affiliations

  1. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sharmila Dorbala MD (Associate Director of Nuclear Cardiology, Instructor in Radiology and Medicine)

  2. Harvard Medical School, Boston, MA, USA

    Marcelo F. Di Carli MD (Chief of Nuclear Medicine, Co-Director of Cardiovascular Imaging, Brigham and Women’s Hospital, Associate Professor of Radiology and Medicine)

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  1. Sharmila Dorbala MD
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  2. Marcelo F. Di Carli MD
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Editors and Affiliations

  1. Harvard Medical School, Boston, Massachusetts, USA

    Marcelo F. Di Carli MD (Chief of Nuclear Medicine, Co-Director of Cardiovascular Imaging, Brigham and Women’s Hospital, Associate Professor of Radiology and Medicine) (Chief of Nuclear Medicine, Co-Director of Cardiovascular Imaging, Brigham and Women’s Hospital, Associate Professor of Radiology and Medicine)

  2. Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA

    Martin J. Lipton MD, FACR, FACC (Director of Education, Non-Invasive Imaging, Brigham and Women’s Hospital, Professor of Radiology) (Director of Education, Non-Invasive Imaging, Brigham and Women’s Hospital, Professor of Radiology)

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Dorbala, S., Di Carli, M.F. (2007). PET and Integrated PET/CT Myocardial Imaging Protocols and Quality Assurance. In: Di Carli, M.F., Lipton, M.J. (eds) Cardiac PET and PET/CT Imaging. Springer, New York, NY. https://doi.org/10.1007/978-0-387-38295-1_10

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  • DOI: https://doi.org/10.1007/978-0-387-38295-1_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-35275-6

  • Online ISBN: 978-0-387-38295-1

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